State Plan

Section Subject
Index Index of the State Plan
Table of Content Table of Contents and State Plan Submittal Statement
Section 1 Single State Agency Organization
Section 2 Coverage and Eligibility
Section 3 Services: General Provisions
Section 4 General Program Administration
Section 5 Personnel Administration
Section 6 Financial Administration
Section 7 General Provisions
Attachment 1.1-A Attorney General's Certification
Attachment 1.2A, 1.2B, 1.2C & 1.2D Organization
Attachment 2.1A Definition of HMO
Attachment 2.2-A Groups Covered and Agencies Responsible for Eligibility Determination
Attachment 2.6-A Eligibility Conditions and Requirements
Attachment 3.1-A Amount, 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-B Amount, 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-C Standards Established and Methods Used to Assure High Quality Care
Attachment 3.1D Methods Used in Assuring Necessary Transportation
Attachment 3.1-E Standards for the Coverage of Organ Transplant Services
Attachment 4.11-A Standards for Institutions
Attachment 4.14B Methods To Be Used in Providing Utilization Review in Intermediate Care Facilities
Attachment 4.16-A Cooperative Arrangement with State Health and Vocational Rehabilitation Agencies
Attachment 4.17-A Liens and Adjustments or Recoveries
Attachments 4.18-A; 4-18-C; 4.18-D and 4.18-E Co-pay, Cost-sharing and Premiums
Attachment 4.19-A Methods and Standards for Establishing Payment Rates for Inpatient Hospital Services
Attachment 4.19B Methods and Standards for Establishing Payment Rates -Other Types of Care
Attachment 4.19-C Methods of Reimbursing for Reserved Beds in Nursing Facilities and Intermediate Care Facilities for the Mentally Retarded
Attachment 4.19D Methods and Standards for Establishing Payment Rates - Nursing Facilities
Attachment 4.19E Timely Claims Payment - Definition of Claim
Attachment 4.20-A Condition for Direct Payment for Physicians' and Dentists' Services
Attachment 4.22-A & 4.22-B Third Party Liability
Attachment 4.22-C State Method on Cost Effectiveness of Employer-Based Group Health Plans
Attachment 4.30 Sanction for Psychiatric Hospitals
Attachment 4.32-A Income and Eligibility Verification System Procedures Requests to Other State Agencies
Attachment 4.33-A Method for Issuance of Medicaid Eligibility Cards to Homeless Individuals
Attachment 4.34-A Requirements for Advance Directives Under State Plans for Medical Assistance
Attachment 4.35-A, B, C, D, E, F, G, & H Enforcement of Compliance for Nursing Facilities
Attachment 4.38 & 4.38A Registry Information
Attachment 4.39 Definition of Specialized Services
Attachment 4.39-A Categorical Determinations
Attachments 4.40-A; 4.40-B; 4.40-C; 4.40-D & 4.40-E Eligibility Conditions and Requirements - Survey and Certification, etc.
Attachment 4.42-A Employee Education About False Claim Recoveries
Attachment 5.1A Merit System
Attachment 7.2-A Methods 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