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[]
[null,"OMES Form Q-1 (2022)",null,null,null,null,null,"GAAP CONVERSION MANUAL",null,null,null,null,null,null,"OMES USE ONLY"]
[null,null,null,null,null,null,null,"MEDICAID SUMMARY",null,null,null,null,null,null,"Review"]
[null,null,null,null,null,null,null,"PRIMARY RECIPIENT ONLY",null,null,null,null,null,null,"2nd Review"]
[null,null,null,null,null,null,null,"MEDICAID PAYABLE AND RECEIVABLE"]
[null,null,null,null,null,null,null,{"$f":"VLOOKUP(W7,'Q-1'!$W$10:$X$25,2,FALSE)","v":"2022-06-30"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"TODAY()","v":"2022-06-15"}]
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[]
[null,null,"-- Complete (1) and (2) and Enter (X) Here If Summary Form Does Not Apply",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Column1","Column2"]
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[null,null,null,"Approved By:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2019,"2019-06-30"]
[null,null,null,null,null,"Finance Officer/Executive Director Name",null,null,null,null,"Title",null,null,"Phone",null,null,null,null,null,null,null,null,2020,"2020-06-30"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2021,"2021-06-30"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2022,"2022-06-30"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2024,"2024-06-30"]
[null,null,"(3) Medicaid A.L. Number",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2025,"2025-06-30"]
[]
[null,null,"(4) Medicaid Payable",null,null,null,null,null,null,null,null,null,null,0]
[]
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[]
[null,null,"(6) Medicaid Non-Federal Receivable",null,null,null,null,null,null,null,null,null,null,0]
[]
[]
[]
[null,null,"(7)","Payments received from other state agencies:",null,null,null,null,null,"  (8) Refunds and other Reimbursements"]
[null,null,null,"Agency #",null,null,"Total Amount Received"]
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[null,null,null,null,null,null,0]
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[null,null,null,null,null,null,0]
[null,null,null,null,null,null,0]
[null,null,null,null,null,null,0,null,null,"      (c) Less:  Civil Monetary Penalties"]
[null,null,null,null,null,null,0,null,null,"           Received",null,null,null,"-",0]
[null,null,null,null,null,null,0]
[null,null,null,null,null,null,0,null,null,null,null,"Total",null,null,{"$f":"O37+O41-O45","v":0}]
[null,null,null,null,null,null,0]
[null,null,null,null,null,"Total",{"$f":"SUM(G37:H48)","v":0}]
[]
[]
[null,"DO NOT WRITE BELOW THIS LINE - FOR OMES USE ONLY"]
[]
[null,null,null,null,null,null,"Account Number",null,null,null,"Dr.",null,null,null,"Cr."]
[null,null,null,"JE Posted:",null,null,"G",807,{"$f":"[1]Cash!$H$70","v":0}]
[null,null,null,"Current Expenditures",null,null,807,{"$f":"[1]Cash!$E$10","v":"01401"},"09",531600]
[null,null,null,"Accounts Payable",null,null,807,{"$f":"[1]Cash!$E$10","v":"01401"},"09","202000"]
[null,null,null,null,null,null,807,{"$f":"[1]Cash!$E$10","v":"01401"},"09"]
[null,null,null,"To Record Medicaid Payable for State per Primary Recipient"]
[]
[null,null,null,"JE Posted:",null,null,"G",807,{"$f":"[1]Cash!$H$70","v":0}]
[null,null,null,"Federal Receivable",null,null,807,{"$f":"[1]Cash!$E$10","v":"01401"},"09","116000"]
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[null,null,null,"To Record Medicaid Receivable & Unearned Revenue for State per Primary Recipient"]

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[]
[null,"OMES Form Q-2 (2015)",null,null,null,null,null,"GAAP CONVERSION MANUAL",null,null,null,null,null,null,null,"OMES USE ONLY"]
[null,null,null,null,null,null,null,"MEDICAID SUMMARY",null,null,null,null,null,null,null,"Review"]
[null,null,null,null,null,null,null,"MEDICAID SERVICE PROVIDERS ONLY",null,null,null,null,null,null,null,"2nd Review"]
[null,null,null,null,null,null,null,"MEDICAID PAYMENTS FROM PRIMARY RECIPIENT"]
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[null,null,"-- Complete (1) and (2) and Enter (X) Here If Summary Form Does Not Apply",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Column1","Column2"]
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[null,null,null,null,null,null,null,"Signature",null,null,null,null,null,null,"Date",null,null,null,null,null,null,null,2023,"2023-06-30"]
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[null,null,"Those state agencies that provide health care services receive Medicaid from the Oklahoma Health Care Authority (OHCA) for their services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2025,"2025-06-30"]
[null,null,"provided to Medicaid-eligible patients during the year.  These agencies and facilities submit claims to OHCA for Medicaid reimbursement for"]
[null,null,"services provided as of June 30.  OHCA, as the primary recipient(s) of Medicaid payments, make the payments and in turn request the"]
[null,null,"Medicaid reimbursement from the Federal Government."]
[]
[null,null,"All agencies receiving Medicaid funds are within the General Fund fund type.  (See GAAP Fund Type Matrix).  Each agency, as well as OHCA"]
[null,null,"records the associated revenues and expenditures.  At the individual agency level this is appropriate."]
[]
[null,null,"However, at the state level, a general fund journal entry is required to remove the double reporting of Medicaid revenues and expenditures."]
[null,null,"This general fund journal entry is made to reduce those revenues and expenditures that have been reported twice in the Office of Managememnt"]
[null,null,"and Enterprise Services' cash basis accounting system (see #3 below) and those expenditures that are included in OHCA's accrual amounts to be paid"]
[null,null,"(see #4 below)."]
[]
[null,null,"Please complete the remainder of this form."]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"Revenue Code(s)",null,null,null,null,null,"Amount"]
[null,null,"(3)  ","Medicaid payments during the year for health services"]
[null,null,null,"that were received from OHCA at June 30."]
[]
[null,null,"(4)","Medicaid payments that as of June 30:"]
[null,null,null,"(a) represent health services provided"]
[null,null,null,null,"and"]
[null,null,null,"(b) have not been received from OHCA"]
[]
[null,null,"(5)","TOTAL",null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(P43:R50)","v":0}]
[]
[]
[null,null,"(6)","Comments:"]

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