State Expenditure Reporting for Medicaid & CHIP
Medicaid & CHIP Expenditure Tracking System
CMS tracks state expenditures through the automated Medicaid Budget and Expenditure System/State Children's Health Insurance Budget and Expenditure System (MBES/CBES).
The MBES/CBES is a web-based application system that has been implemented nationwide. The system allows states to report budgeted and actual expenditures for Medicaid and the Children’s Health Insurance Program (CHIP), by electronically submitting their Form CMS-64 directly to the CMS Data Center and the Medicaid data base.
The system uses the information from each state to compute the amount of Federal Financial Participation (FFP) the Agency will provide to the state to fund program operations. The MBES/CBES also stores the state’s historical budget and expenditure records for data analysis purposes.
Medicaid Program Expenditure Forms
Two series of forms detail the quarterly anticipated and actual budget for Medicaid and CHIP. The forms distinguish between budget and costs associated with the program’s medical services, and budget and costs associated with program administration.
- CMS-37 form series: identifies anticipated quarterly budgeted costs
- CMS-64 form series: identifies actual quarterly expenses
States use both series of forms to input budget and expenditure data into the MBES/CBES. Based on the CMS-37 submission, CMS issues a grant award to the state authorizing federal Medicaid funding to the state for the certified quarter.
For details on the claims process and requirements see Title 42 Part 430.30 of the Code of Federal Regulations.
CMS produces summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs as well as summary state-specific data from the CMS-64 and the CMS-21. Most recently, CMS reports summary level expenditure data associated with the new adult group established under the Affordable Care Act.
See available summary level data and expenditure reports from MBES/CBES.
Expenditures Must Reconcile
The amounts reported on and its attachments must be actual expenditures for which all supporting documentation, in readily reviewable form, has been compiled and is available immediately at the time the claim is filed. Form CMS-64 is a statement of expenditures for which states are entitled to Federal reimbursement under Title XIX and which reconciles the monetary advance made on the basis of Form CMS-37 filed previously for the same quarter. Consequently, the amount claimed on the Form CMS-64 is a summary of expenditures derived from source documents such as invoices, cost reports and eligibility records. All summary statements or descriptions of each claim must identify the claim and source documentation. Claims developed through the use of sampling, projections, or other estimating techniques are considered estimates and are not allowable under any circumstances. Where states are unable to develop and document a claim for expenditures on a current basis, they must withhold it until the actual amount, supported by final documentation, has been determined. The state must report that amount on a future Form CMS-64 as a prior period adjustment.