State Plan
SECTION 1 - Single State Agency Organization
- 1.1 Designation and Authority
- 1.2 Organization for Administration
- 1.3 Statewide Operation
- 1.4 State Medical Care Advisory Committee
- 1.5 Pediatric Immunization Program
SECTION 2 - Coverage And Eligibility
- 2.1 Application, Determination of Eligibility and Furnishing Medicaid
- 2.2 Coverage and Conditions of Eligibility
- 2.3 Residence
- 2.4 Blindness
- 2.5 Disability
- 2.6 Financial Eligibility
- 2.7 Medicaid Furnished Out of State
SECTION 3 - Services: General Provisions
- 3.1 Amount, Duration, and Scope of Services
- 3.2 Coordination of Medicaid with Medicare Part B
- 3.3 Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases
- 3.4 Special Requirements Applicable to Sterilization Procedures
- 3.5 Medicaid for Medicare Cost Sharing for Qualified Medicare Beneficiaries
- 3.6 Ambulatory Prenatal Care for Pregnant Women during Presumptive Eligibility Period
SECTION 4 - General Program Administration
- 4.1 Methods of Administration
- 4.2 Hearings for Applicants and Recipients
- 4.3 Safeguarding Information on Applicants and Recipients
- 4.4 Medicaid Quality Control
- 4.5 Medicaid Agency Fraud Detection and Investigation Program
- 4.6 Reports
- 4.7 Maintenance of Records
- 4.8 Availability of Agency Program Manuals
- 4.9 Reporting Provider Payments to the Internal Revenue Service
- 4.10 Free Choice of Providers
- 4.11 Relations with Standard-Setting and Survey Agencies
- 4.12 Consultation to Medical Facilities
- 4.13 Required Provider Agreement
- 4.14 Utilization Control
- 4.15 Inspection of Care in Skilled Nursing and Intermediate Care Facilities and Institutions for Mental Diseases
- 4.16 Relations with State Health and Vocational Rehabilitation Agencies and Title V Grantees
- 4.17 Liens and Recoveries
- 4.18 Cost Sharing and Similar Charges
- 4.19 Payment for Services
- 4.20 Direct Payments to Certain Recipients for Physicians' or Dentists' Services
- 4.21 Prohibition Against Reassignment of Provider Claims
- 4.22 Third Party Liability
- 4.23 Use of Contracts
- 4.24 Standards for Payments for Skilled Nursing and Intermediate Care Facility Services
- 4.25 Program for Licensing Administrators of Nursing Homes
- 4.26 Drug Utilization Review Program
- 4.27 Disclosure of Survey Information and Provider or Contractor Evaluation
- 4.28 Appeals Process for Skilled Nursing and Intermediate Care Facilities
- 4.29 Conflict of Interest Provisions
- 4.30 Exclusion of Providers and Suspension of Practitioners Convicted and Other Individuals
- 4.31 Disclosure of Information by Providers and Fiscal Agents
- 4.32 Income and Eligibility Verification System
- 4.33 Medicaid Eligibility Cards for Homeless Individuals
- 4.34 Systematic Alien Verification for Entitlement
- 4.35 Remedies for Skilled Nursing and Intermediate Care Facilities that Do No Meet Requirements of Participation
- 4.36 Required Coordination Between the Medicaid and WIC Programs
- 4.37 [Reserved]
- 4.38 Nurse Aide Training and Competency Evaluation For Nursing Facilities
- 4.39 Preadmission Screening and Annual Resident Review in Nursing Facilities
- 4.40 Survey & Certification Process
- 4.41 Resident Assessment for Nursing Facilities
- 4.42 Employee Education About False Claims Recoveries
SECTION 5 - Personnel Administration
- 5.1 Standards of Personnel Administration
- 5.2 [Reserved]
- 5.3 Training Program: Sub-professional and Volunteer Programs
SECTION 6 - Financial Administration
- 6.1 Fiscal Policies and Accountability
- 6.2 Cost Allocation
- 6.3 State Financial Participation
SECTION 7 - General Provisions
- 7.1 Plan Amendments
- 7.2 Nondiscrimination
- 7.3 State Governor's Review
- 7.4 State Governor's Review