State Plan

SectionSubject
IndexIndex of the State Plan
Table of ContentTable of Contents and State Plan Submittal Statement
Section 1Single State Agency Organization
Section 2Coverage and Eligibility
Section 3Services: General Provisions
Section 4General Program Administration
Section 5Personnel Administration
Section 6Financial Administration
Section 7General Provisions
Attachment 1.1-AAttorney General's Certification
Attachment 1.2A, 1.2B, 1.2C & 1.2DOrganization
Attachment 2.1ADefinition of HMO
Attachment 2.2-AGroups Covered and Agencies Responsible for Eligibility Determination
Attachment 2.6-AEligibility Conditions and Requirements
Attachment 3.1-AAmount, Duration Scope of Medical Care and Services Provided to Categorically Needy; Limitation on amount duration and scope of medical care and services provider
Attachment 3.1-BAmount, Duration Scope of Medical Care and Services Provided Medically Needy Group (s); Limitation on amount duration and scope of medical care and services provider
Attachment 3.1-CStandards Established and Methods Used to Assure High Quality Care
Attachment 3.1DMethods Used in Assuring Necessary Transportation
Attachment 3.1-EStandards for the Coverage of Organ Transplant Services
Attachment 3.1-L1915(l) State Plan Option
Attachment 4.11-AStandards for Institutions
Attachment 4.14BMethods To Be Used in Providing Utilization Review in Intermediate Care Facilities
Attachment 4.16-ACooperative Arrangement with State Health and Vocational Rehabilitation Agencies
Attachment 4.17-ALiens and Adjustments or Recoveries
Attachments 4.18-A; 4-18-C; 4.18-D and 4.18-ECo-pay, Cost-sharing and Premiums
Attachment 4.19-AMethods and Standards for Establishing Payment Rates for Inpatient Hospital Services
Attachment 4.19BMethods and Standards for Establishing Payment Rates -Other Types of Care
Attachment 4.19-CMethods of Reimbursing for Reserved Beds in Nursing Facilities and Intermediate Care Facilities for the Mentally Retarded
Attachment 4.19DMethods and Standards for Establishing Payment Rates - Nursing Facilities
Attachment 4.19ETimely Claims Payment - Definition of Claim
Attachment 4.20-ACondition for Direct Payment for Physicians' and Dentists' Services
Attachment 4.22-A & 4.22-BThird Party Liability
Attachment 4.22-CState Method on Cost Effectiveness of Employer-Based Group Health Plans
Attachment 4.30Sanction for Psychiatric Hospitals
Attachment 4.32-AIncome and Eligibility Verification System Procedures Requests to Other State Agencies
Attachment 4.33-AMethod for Issuance of Medicaid Eligibility Cards to Homeless Individuals
Attachment 4.34-ARequirements for Advance Directives Under State Plans for Medical Assistance
Attachment 4.35-A, B, C, D, E, F, G, & HEnforcement of Compliance for Nursing Facilities
Attachment 4.38 & 4.38ARegistry Information
Attachment 4.39Definition of Specialized Services
Attachment 4.39-ACategorical Determinations
Attachments 4.40-A; 4.40-B; 4.40-C; 4.40-D & 4.40-EEligibility Conditions and Requirements - Survey and Certification, etc.
Attachment 4.42-AEmployee Education About False Claim Recoveries
Attachment 5.1AMerit System
Attachment 7.2-AMethods of Administration

Supplemental State Plan Pages

The Centers for Medicare & Medicaid Services (CMS) is in the process of transitioning the Medicaid State Plan approval process from a paper-based process to an electronic process. State Plan authorities approved under the new electronic process are listed below. Unless otherwise noted, these State Plan sections supersede any other paper State Plan sections listed above.

Organization & Administration

Eligibility & Enrollment Process

Non-Financial Eligibility

Income/Resource Methodologies

Income/Resource Standards

Eligibility Groups – Mandatory Coverage

Eligibility Groups – Options for Coverage

Eligibility Groups – Medically Needy

Medicaid Benefits – Health Home