The Quarterly State Children's Health Insurance Program (SCHIP) Statement of Expenditures for Title XXI (Form CMS-21) is the state's accounting statement of actual recorded expenditures and the disposition of Federal funds which the states, in accordance with Sections 2105(e) and 2107(b)(1) of the Act, must submit each quarter under Title XXI of the Act.  Expenditures reported on this form primarily include those made to initiate and expand health insurance coverage to uninsured, low-income children through a separate SCHIP.  Administrative costs associated with expanding child health insurance coverage to uninsured, low-income children through an expansion of a State Medicaid program may also be included on the Form CMS-21 if the state opts to claim Federal Financial Participation at the enhanced Federal Medical Assistance Percentage. Program services costs associated with expanding child health insurance coverage to uninsured, low-income children through an expansion of a State Medicaid program are not reported on the Form CMS-21. These costs are reported on the Form CMS-64, Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program.

The Form CMS-21 shows the disposition of Federal SCHIP grant funds for the quarter being reported and previous fiscal quarters and years, recoupments made or refunds received, adjustments for overpayments or underpayments, and adjustments for premiums or cost-sharing amounts received.

The amounts reported on Form CMS-21 and its attachments must be actual recorded 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-21 is an accounting statement of actual expenditures for which states are entitled to Federal reimbursement under Title XXI and which reconciles any advance of Title XXI Federal funds made on the basis of estimates provided on the Form CMS-21B. Reconciliations of expenditures to estimates, however, will not occur until after the period of availability for allotments has expired.

The amount claimed on the Form CMS-21 is a summary of actual 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. If a state is unable to develop and document a claim for expenditures on a current basis, the state must withhold the claim until the actual amount, supported by final documentation, has been determined. The state then reports that amount on a future Form CMS-21P as a prior period adjustment.

The WEB-based Medicaid and SCHIP Budget and Expenditure System (MBES/CBES) has allowed the states to electronically submit their Form CMS-21 directly to the CMS Data Center and the Medicaid/SCHIP data base. When using the MBES/CBES, states do not have to submit a hardcopy of the signed certification statement to CMS. We have modified the MBES/CBES to allow states to complete the signature/certification form through the MBES/CBES and simply transmit this form to us. Signed hard copies must be maintained at the state.

Summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and SCHIP programs are now available and can be downloaded from the PDF or Excel ZIP file.  (see the link in the "Downloads section below)

Summary state-specific data from the CMS-64 and the CMS-21 are available for download directly from this site. The download Financial Management Reports (FMR) file buttons will give you access to "zipped" files (FMRyy.ZIP). Each zip file contains spreadsheet files containing the financial data for the Federal Fiscal Year specified. The unzipped file can be identified as follows: on the left-side of the spreadsheet at the top is the regular Title XIX Medicaid expenditures; about half way down the left-side of the spreadsheet is a "C-" in front of the service category this denotes Medicaid SCHIP expansion population; on the right side of the spreadsheet at the top is Title XIX Medicaid Administration expenditures; one half way down the right side of the spreadsheet is regular Title XXI SCHIP expenditures.

The "CSV" extension is for files with comma separated values.  To download financial management report from 1997-2005 see the links in the "Downloads" section below.

See the links in the "Downloads" section below to download the Medicaid and SCHIP forms and instructions in a file.

Downloads
1997 through 2001 [PDF, 244KB] 1997 through 2001 [ZIP, 32KB] Download Financial Management Report for FY-2005 [ZIP, 80KB] Download Financial Management Report for FY-2004 [ZIP, 85KB] Download Financial Management Report for FY-2003 [ZIP, 82KB] Download Financial Management Report for FY-2002 [ZIP, 78KB] Download Financial Management Report for FY-2001 [ZIP, 73KB] Download Financial Management Report for FY-2000 [ZIP, 75KB] Download Financial Management Report for FY-1999 [ZIP, 70KB] Download Financial Management Report for FY-1998 [ZIP, 58KB] Download Financial Management Report for FY-1997 [ZIP, 38KB] Form CMS-21B [PDF, 13KB] Form CMS-21 [PDF, 47KB] Form CMS-21C (Allotment Tracking Form) [PDF, 47KB] Form CMS-37 [PDF, 44KB] Form CMS-64.21 [PDF, 121KB] MBES/CBES Guides [ZIP, 11.5MB]
Related Links Inside CMS
Quarterly Expense Report (CMS-64) Medicaid Program Budget Report (CMS-37)
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 03/05/2007 10:01:04 AM
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