Federal Supplementary Medical Insurance Trust Fund and 2 other accounts

B1: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 25, 2003 has exempted the basic HI/SMI benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B2: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 17, 2013 has exempted the Part D benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B3: These amounts reflect an adjustment to the funds sequestered for FY 2022 pursuant to the FY 2022 Joint Committee sequestration, in accordance with Section 3709(a) of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), as amended by Public Law 116-260 and further amended by Public Law 117-7, which suspended the sequestration of Medicare programs under tile XVIII of the Social Security Act from May 1, 2020 until December 31, 2021.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B4: Amounts apportioned for "Other CMMI Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for three demonstrations: Primary Care First; Comprehensive Primary Care Plus; and Global and Professional Direct Contracting.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B5: Amounts apportioned for "All Other Medicare Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for two demonstrations: Independence at Home and Frontier Community Health Integration Project.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

A3: HHS may incur obligations for these administrative costs from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or 75-X-8308. These apportioned amounts cap the total administrative obligations that HHS may incur for these demonstrations using funds from any combination of these Treasury accounts.

A4: Details on attachments other than sheet 3 are not subject to 31 USC 1517. The term "attachments" includes but is not limited to the worksheets in this excel file that accompany the SF 132 and this footnote worksheet.

A5: Amounts apportioned on line 6190 are available only to support 11 FTEs. Consistent with section 120.9 of OMB Circular A-11, OMB is working with HHS in reviewing CMS's FTE cost allocation methodology and will address funding for FTEs in a subsequent apportionment action as necessary.

B1: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 25, 2003 has exempted the basic HI/SMI benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B2: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 17, 2013 has exempted the Part D benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B3: These amounts reflect an adjustment to the funds sequestered for FY 2022 pursuant to the FY 2022 Joint Committee sequestration, in accordance with Section 3709(a) of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), as amended by Public Law 116-260 and further amended by Public Law 117-7, which suspended the sequestration of Medicare programs under tile XVIII of the Social Security Act from May 1, 2020 until December 31, 2021.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B4: Amounts apportioned for "Other CMMI Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for three demonstrations: Primary Care First; Comprehensive Primary Care Plus; and Global and Professional Direct Contracting.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B5: Amounts apportioned for "All Other Medicare Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for two demonstrations: Independence at Home and Frontier Community Health Integration Project.

A3: HHS may incur obligations for these administrative costs from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or 75-X-8308. These apportioned amounts cap the total administrative obligations that HHS may incur for these demonstrations using funds from any combination of these Treasury accounts.

A4: Details on attachments other than sheet 3 are not subject to 31 USC 1517. The term "attachments" includes but is not limited to the worksheets in this excel file that accompany the SF 132 and this footnote worksheet.

A5: Amounts apportioned on line 6190 are available only to support 11 FTEs. Consistent with section 120.9 of OMB Circular A-11, OMB is working with HHS in reviewing CMS's FTE cost allocation methodology and will address funding for FTEs in a subsequent apportionment action as necessary.

B1: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 25, 2003 has exempted the basic HI/SMI benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B2: Pursuant to 31 U.S.C. 1516 and OMB Circular No. A-11, Section 120.5, OMB in the policy letter of September 17, 2013 has exempted the Part D benefit category from the standard apportionment requirements contained in title 31 of the U.S. Code.

B3: These amounts reflect an adjustment to the funds sequestered for FY 2022 pursuant to the FY 2022 Joint Committee sequestration, in accordance with Section 3709(a) of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), as amended by Public Law 116-260 and further amended by Public Law 117-7, which suspended the sequestration of Medicare programs under tile XVIII of the Social Security Act from May 1, 2020 until December 31, 2021.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B4: Amounts apportioned for "Other CMMI Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for three demonstrations: Primary Care First; Comprehensive Primary Care Plus; and Global and Professional Direct Contracting.

A1: Per statute, HHS can incur obligations for these demonstrations from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or, 75-X-8308. As the demonstrations are not fully financed from any single account, and cannot be estimated by account, full demonstration costs are reflected in each account per agreement with OMB.

A2: The dollar amount that the apportionment identifies for each demonstration is an estimate of the funding that will be required during this fiscal year to carry out that demonstration in accordance with its existing terms, conditions and timetables. Accordingly, for purposes of 31 U.S.C. 1514 and 1517, the apportioned amount is not the estimate but is instead the full amount of funding that is necessary during this fiscal year to carry out the demonstration in accordance with its existing terms, conditions and timetables. In the case that the allocation of any single demonstration included on sheet 7 is projected to exceed the specified amounts on sheet 7, CMS must notify OMB in writing within 15 days of determining demonstration outlays will exceed specified projections. This apportionment does not apportion any funding for any extension of a demonstration or for any modification to a demonstration's existing terms, conditions, and/or timetables. Therefore, a future reapportionment will be necessary in order for funding to be available for obligation for any extension or modification.

B5: Amounts apportioned for "All Other Medicare Demonstrations" differ from the agency requested level due to revised estimates provided by the requesting agency following the submission of the apportionment for OMB review for two demonstrations: Independence at Home and Frontier Community Health Integration Project.

A3: HHS may incur obligations for these administrative costs from any of three different Treasury accounts: 75-75-X-8004; 75-75-X-8005; or 75-X-8308. These apportioned amounts cap the total administrative obligations that HHS may incur for these demonstrations using funds from any combination of these Treasury accounts.

A4: Details on attachments other than sheet 3 are not subject to 31 USC 1517. The term "attachments" includes but is not limited to the worksheets in this excel file that accompany the SF 132 and this footnote worksheet.

A5: Amounts apportioned on line 6190 are available only to support 11 FTEs. Consistent with section 120.9 of OMB Circular A-11, OMB is working with HHS in reviewing CMS's FTE cost allocation methodology and will address funding for FTEs in a subsequent apportionment action as necessary.