Get Cost Neutral Budget Amendment Opwdd

Filling out the Cost Neutral Budget Amendment Opwdd online is an important step for participants seeking to make budget adjustments without requesting new services. This guide provides a clear, step-by-step approach to help users navigate the form efficiently.

Follow the steps to successfully complete your budget amendment.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the participant's name and Medicaid ID number in the designated fields.
3. Provide the requested effective date for the budget amendment.
4. Enter the TABS ID number and the DDRO information in the appropriate sections.
5. In the Medicaid Funded Services section, check the services that are being reduced in Column A and enter the corresponding dollar amount in Column B. Then check the services that are being increased in Column C and input the amount in Column D. Ensure that the totals from the ‘MA Funded Sum’ columns match.
6. Proceed to the NY State Funded Services section, where you will again check the reduced services in Column E and enter the amounts in Column F, followed by checking the increased services in Column G and entering those amounts in Column H. Confirm that the totals from the ‘State Funded Sum’ columns match.
7. Utilize the provided space to describe any other cost neutral amendments to the Self-Direction Budget that are not reflected in the previous sections.
8. Collect required signatures: the participant or their designee must sign and date. A broker and FI staff member's signature may also be necessary.
9. Submit the completed form to the regional Self-Direction Liaison, along with all necessary supporting documentation, such as the budget.
10. If approved, make sure to note the effective date and ensure the signed original is forwarded to the FI, with copies sent to the relevant parties.

Complete your Cost Neutral Budget Amendment Opwdd online now to ensure your budget adjustments are processed promptly.