ITEM II Revenue Expense Projections through June 2013 Updated March 22, 2013 Jan - Jun 12 Actual Waiver Service Revenue Waiver Service Expenses Waiver Service Surplus/Loss Waiver Administration Revenue Waiver Administration Expenses Waiver Administration Surplus/Loss Net Waiver Surplus/Loss Risk Reserve Jul - Dec 12 Actual Jan-Feb 13 Actual 13-Mar Projected** Apr - Jun 13 Projected Total $58,330,279 $65,126,997 -$6,796,718 $60,058,410 $61,804,217 -$1,745,807 $21,883,713 $18,726,079 $3,157,634 $11,392,087 $10,510,375 $881,711 $33,441,288 $30,853,035 $2,588,253 $185,105,777 $187,020,703 -$1,914,926 $8,132,723 $5,625,977 $2,506,746 $8,370,170 $7,168,662 $1,201,508 $2,829,475 $2,707,806 $121,669 $1,440,786 $1,388,457 $52,329 $4,363,577 $4,165,372 $198,205 $25,136,731 $21,056,274 $4,080,457 -$4,289,972 -$544,298 $3,279,303 $934,041 $2,786,458 $2,165,531 $1,355,454 $1,395,028 $504,324 $254,107 $843,776 $4,352,689 **March Revenue Actual Added Additional PMPM for IDD Slots (25-April; 50- May; 105-June) Expenses Added for IDD Care Coordination Slots/Offsetting Expenses for IDD Services Additional $375,000 Added for Consulting Fees to April-June Projection Non-Waiver Revenue Expense Projections through June 2013 Jul - Feb 13 Non-Waiver Service Revenue Non-Waiver Service Expenses Non-Waiver Service Surplus/Loss Non-Waiver Administration Revenue Non-Waiver Adminisgtration Expenses Non-Waiver Administration Surplus/Loss Net Non-Waiver Surplus/Loss 13-Mar Projected Apr - Jun 13 Projected Total $20,609,796 $20,403,893 $205,903 $2,237,727 $2,192,062 $45,666 $6,610,393 $6,522,835 $87,558 $29,457,916 $29,118,789 $339,127 $2,548,528 $2,316,769 $231,760 $393,416 $347,612 $45,804 $745,166 $707,907 $37,259 $3,687,110 $3,372,288 $314,823 $437,663 $91,470 $124,817 $653,950 *Out of the $29,457,916 of Non-Waiver revenues, $23,219,032 is for affiliate contracts processed manually and paid monthly the lesser of 1/12th or actual expenses/earnings and MOE funds which pay out dollar for dollar. **Service expenditures are estimated at 98% of revenues ***Administration expenditures are estimated at 95% of revenues *****The Division of Mental Health (DMH) has implemented a "Community Efficiency Plan" which requires LME/MCO's to earn 100% of their allocations in Single Stream, both IPRS fee for service shadow claims and Non-UCR for expenditure based programs. The Single Stream payments are being withheld until the 100% target earnings/expenses are met. As of March 25, 2013, WHN was short $1.7 million in IPRS shadow claims. The State is calculating the earnings for the Community Efficiency Plan based on date of service beginning July 1, 2012 which leaves us short the May and June services adjudicated in the subsequent fiscal year. This is a state-wide issue and the MCO's are working together for resolution.