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MEDICAID | MEDICAIDELIGIBILITYESTATE RECOVERYAUTISM SERVICESCOVERED OUTPATIENT DRUGS POLICYHOSPICE BENEFITS Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.WELCOME | DQ ATLAS
DQ (Data Quality) Atlas includes data quality information that supports insightful, methodologically sound analyses using the T-MSIS Analytic Files (TAF) Research Identifiable Files (RIF). Select one of the below pathways to explore key Medicaid and Children’s Health Insurance Program (CHIP) topics such as enrollment, claims,expenditures
MEDICAID ANALYTIC EXTRACT (MAX) GENERAL INFORMATION The Medicaid Analytic eXtract (MAX) data is a set of person-level data files on Medicaid eligibility, service utilization, and payments. The MAX data are created to support research and policy analysis. The MAX data are extracted from the Medicaid Statistical Information System (MSIS). The MAX development process combines MSIS initial claims, interim claims, voids, and adjustments for a given IT IS TIME TO RENEW YOUR MEDICAID COVERAGE. It is time to renew your Medicaid coverage. You can renew your Medicaid in any one of these ways Renewing online is faster! Go to and click on Renew My Medicaid By phone: Just call 1-800-XXX-XXXX (TTY: 1-888-XXX-XXXX). The call is free. By mail: Complete this form andmail it to:
IMPROVING BEHAVIORAL HEALTH FOLLOW-UP CARE LEARNING The Centers for Medicare & Medicaid Services (CMS) launched the “Improving Behavioral Health Follow-Up Care Learning Collaborative” (Learning Collaborative) to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies’ efforts to improve access to and coordination of follow-up care for beneficiaries who visit an emergency department or are hospitalizedfor a mental
FOSTER CARE LEARNING COLLABORATIVE: IMPROVING TIMELY Children and youth eligible for Title IV-E foster care payments are automatically eligible for Medicaid. While they represent less than 2 percent of all children enrolled in Medicaid, children and youth in foster care are an especially vulnerable population whose safety and well-being are the legal responsibility of the state, specifically the Medicaid and child welfare agencies. MEDICAID NCCI 2021 CODING POLICY MANUAL The principles of correct coding discussed in Chapter I apply to Current Procedural Terminology (CPT) codes in the range 90000-99999. Several general guidelines are SMD# 21-003: IMPLEMENTATION OF AMERICAN RESCUE PLAN ACT OF DEPARTMENT OF HEALTH & HUMAN SERVICES . Centers for Medicare & Medicaid Services . 7500 Security Boulevard, Mail Stop S2-26-12 . Baltimore, Maryland 21244-1850 NEW JERSEY WAIVER FACTSHEET NJ Community Care Waiver (0031.R06.00) Provides case management, day habilitation, individual supports, prevocational training services, respite, supported employment - individual employment support, support coordination, assistive technology, behavioral supports, career planning, community transition services, environmental modifications MEDICAID.GOV: THE OFFICIAL U.S. GOVERNMENT SITE FORFEDERAL POLICY GUIDANCEBASIC HEALTH PROGRAMMEDICAID AND CHIP ELIGIBILITY & ENROLLMENTWEBINARS
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MEDICAID | MEDICAIDELIGIBILITYESTATE RECOVERYAUTISM SERVICESCOVERED OUTPATIENT DRUGS POLICYHOSPICE BENEFITS Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.WELCOME | DQ ATLAS
DQ (Data Quality) Atlas includes data quality information that supports insightful, methodologically sound analyses using the T-MSIS Analytic Files (TAF) Research Identifiable Files (RIF). Select one of the below pathways to explore key Medicaid and Children’s Health Insurance Program (CHIP) topics such as enrollment, claims,expenditures
MEDICAID ANALYTIC EXTRACT (MAX) GENERAL INFORMATION The Medicaid Analytic eXtract (MAX) data is a set of person-level data files on Medicaid eligibility, service utilization, and payments. The MAX data are created to support research and policy analysis. The MAX data are extracted from the Medicaid Statistical Information System (MSIS). The MAX development process combines MSIS initial claims, interim claims, voids, and adjustments for a given IT IS TIME TO RENEW YOUR MEDICAID COVERAGE. It is time to renew your Medicaid coverage. You can renew your Medicaid in any one of these ways Renewing online is faster! Go to and click on Renew My Medicaid By phone: Just call 1-800-XXX-XXXX (TTY: 1-888-XXX-XXXX). The call is free. By mail: Complete this form andmail it to:
IMPROVING BEHAVIORAL HEALTH FOLLOW-UP CARE LEARNING The Centers for Medicare & Medicaid Services (CMS) launched the “Improving Behavioral Health Follow-Up Care Learning Collaborative” (Learning Collaborative) to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies’ efforts to improve access to and coordination of follow-up care for beneficiaries who visit an emergency department or are hospitalizedfor a mental
FOSTER CARE LEARNING COLLABORATIVE: IMPROVING TIMELY Children and youth eligible for Title IV-E foster care payments are automatically eligible for Medicaid. While they represent less than 2 percent of all children enrolled in Medicaid, children and youth in foster care are an especially vulnerable population whose safety and well-being are the legal responsibility of the state, specifically the Medicaid and child welfare agencies. MEDICAID NCCI 2021 CODING POLICY MANUAL The principles of correct coding discussed in Chapter I apply to Current Procedural Terminology (CPT) codes in the range 90000-99999. Several general guidelines are SMD# 21-003: IMPLEMENTATION OF AMERICAN RESCUE PLAN ACT OF DEPARTMENT OF HEALTH & HUMAN SERVICES . Centers for Medicare & Medicaid Services . 7500 Security Boulevard, Mail Stop S2-26-12 . Baltimore, Maryland 21244-1850 NEW JERSEY WAIVER FACTSHEET NJ Community Care Waiver (0031.R06.00) Provides case management, day habilitation, individual supports, prevocational training services, respite, supported employment - individual employment support, support coordination, assistive technology, behavioral supports, career planning, community transition services, environmental modificationsELIGIBILITY
Eligibility. Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to over 72.5 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coveragein the United
COVERAGE AND REIMBURSEMENT OF COVID-19 VACCINES, VACCINE 1 May 5, 2021 . Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration, and Cost-Sharing under Medicaid, the Children’s Health Insurance Program, and Basic OUTCOMES-BASED CERTIFICATION The Centers for Medicare & Medicaid Services (CMS) has begun to transition its systems certification process to one that evaluates how well Medicaid information technology systems support desired business outcomes while reducing the burden on states. This streamlined, outcomes-based approach, or “Outcomes-Based Certification (OBC),” is designed to ensure that systems that receive federal PERCENTAGE OF POPULATION ENROLLED IN MEDICAID OR CHIP BY 24.1% to 36.3%. Wisconsin. 17.1% to 21.8%. Wyoming. 9.0 to 17.0%. Source: The percentage of each state’s population enrolled in Medicaid or CHIP was calculated by dividing Medicaid and CHIP enrollment by estimates of each state’s population. Medicaid & CHIP enrollment data come from Updated July 2019 Applications, Eligibility,and
TRANSFORMED MEDICAID STATISTICAL INFORMATION SYSTEM (T With the on-going changes to the national health care environment, the Centers for Medicare & Medicaid Services (CMS) has made significant investments to meet the organizational and information technology (IT) infrastructure to adequately represent CMS’ role in the healthcare marketplace. The Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systemsCONTRACT REVIEW
This guide (PDF, 1.61 MB) covers the standards that are used by CMS staff to review and approve state contracts with Medicaid MCOs, PIHPs, PAHPs, primary care case managers, primary care case management entities, and health insuring organizations. This guide is based on existing requirements and CMS policy at 42 CFR §438. HOME & COMMUNITY BASED SETTINGS REQUIREMENTS COMPLIANCE The Center for Medicaid and CHIP Services (CMCS) is pleased to share with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements in the recently published Home and SHO# 20-004 OF NORMAL STATE MEDICAID, PROGRAM (CHIP), AND DEPARTMENT OF HEALTH & HUMAN SERVICES . Centers for Medicare & Medicaid Services . 7500 Security Boulevard, Mail Stop S2-26-12 . Baltimore, Maryland 21244-1850 MEDICAID HEALTH HOMES: SPA OVERVIEW Medicaid Health Homes: SPA Overview 3 State Model SPA Purpose MD-18-0008: Increases payment rates for health homes (approved 10/16/18, effective 7/1/18)ARIZONA | MEDICAID
has expanded coverage to low-income adults. As of December 2019, has enrolled 985,201 individuals in Medicaid and CHIP — a net increase of 57.29% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. has adopted one or more of the targeted enrollment strategies outlined in guidance CMSissued
MEDICAID.GOV: THE OFFICIAL U.S. GOVERNMENT SITE FORFEDERAL POLICY GUIDANCEBASIC HEALTH PROGRAMMEDICAID AND CHIP ELIGIBILITY & ENROLLMENTWEBINARS
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MEDICAID | MEDICAIDELIGIBILITYESTATE RECOVERYAUTISM SERVICESCOVERED OUTPATIENT DRUGS POLICYHOSPICE BENEFITS Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.WELCOME | DQ ATLAS
DQ (Data Quality) Atlas includes data quality information that supports insightful, methodologically sound analyses using the T-MSIS Analytic Files (TAF) Research Identifiable Files (RIF). Select one of the below pathways to explore key Medicaid and Children’s Health Insurance Program (CHIP) topics such as enrollment, claims,expenditures
IT IS TIME TO RENEW YOUR MEDICAID COVERAGE. It is time to renew your Medicaid coverage. You can renew your Medicaid in any one of these ways Renewing online is faster! Go to and click on Renew My Medicaid By phone: Just call 1-800-XXX-XXXX (TTY: 1-888-XXX-XXXX). The call is free. By mail: Complete this form andmail it to:
DATA.MEDICAID.GOV
2021 Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244 ADULT CORE SET REPORTING RESOURCES Additional Reporting Resources. 2021 Adult Core Set HEDIS Measures Value Set Directory (ZIP, 2.78 MB) 2021 Adult Core Set Non-HEDIS Measures Value Set Directory (ZIP, 351.21 KB) 2021 Adult COB/OHD Value Set Directory (ZIP, 1.13 MB) 2021 Adult Core Set Measurement Periods (PDF, 198.82 KB) 2021 Core Set Data Quality Checklist (PDF, 793.61 KB) CHILD CORE SET REPORTING RESOURCES Additional Reporting Resources. 2021 Child Core Set HEDIS Value Set Directory (ZIP, 1.03 MB) 2021 Child Core Set Non-HEDIS Value Set Directory (ZIP, 210.13 KB) 2021 Child Core Set Measurement Periods (PDF, 171.77 KB) 2021 Core Set Data Quality Checklist (PDF, 793.61 KB) Technical Assistance Resource: Calculating State-Level Rates UsingData
EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENTSEE MORE ONMEDICAID.GOV
FOSTER CARE LEARNING COLLABORATIVE: IMPROVING TIMELY Children and youth eligible for Title IV-E foster care payments are automatically eligible for Medicaid. While they represent less than 2 percent of all children enrolled in Medicaid, children and youth in foster care are an especially vulnerable population whose safety and well-being are the legal responsibility of the state, specifically the Medicaid and child welfare agencies. MBES/CBES WARNING PAGE MBES/CBES Warning Page. **WARNING**WARNING**WARNING**. UNAUTHORIZED ACCESS TO THIS COMPUTER IS PROHIBITED BY LAW (REFERENCE TITLE 18 U.S.C., SECTION 1030). This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Govermnent system, whichincludes
MEDICAID.GOV: THE OFFICIAL U.S. GOVERNMENT SITE FORFEDERAL POLICY GUIDANCEBASIC HEALTH PROGRAMMEDICAID AND CHIP ELIGIBILITY & ENROLLMENTWEBINARS
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MEDICAID | MEDICAIDELIGIBILITYESTATE RECOVERYAUTISM SERVICESCOVERED OUTPATIENT DRUGS POLICYHOSPICE BENEFITS Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.WELCOME | DQ ATLAS
DQ (Data Quality) Atlas includes data quality information that supports insightful, methodologically sound analyses using the T-MSIS Analytic Files (TAF) Research Identifiable Files (RIF). Select one of the below pathways to explore key Medicaid and Children’s Health Insurance Program (CHIP) topics such as enrollment, claims,expenditures
IT IS TIME TO RENEW YOUR MEDICAID COVERAGE. It is time to renew your Medicaid coverage. You can renew your Medicaid in any one of these ways Renewing online is faster! Go to and click on Renew My Medicaid By phone: Just call 1-800-XXX-XXXX (TTY: 1-888-XXX-XXXX). The call is free. By mail: Complete this form andmail it to:
DATA.MEDICAID.GOV
2021 Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244 ADULT CORE SET REPORTING RESOURCES Additional Reporting Resources. 2021 Adult Core Set HEDIS Measures Value Set Directory (ZIP, 2.78 MB) 2021 Adult Core Set Non-HEDIS Measures Value Set Directory (ZIP, 351.21 KB) 2021 Adult COB/OHD Value Set Directory (ZIP, 1.13 MB) 2021 Adult Core Set Measurement Periods (PDF, 198.82 KB) 2021 Core Set Data Quality Checklist (PDF, 793.61 KB) CHILD CORE SET REPORTING RESOURCES Additional Reporting Resources. 2021 Child Core Set HEDIS Value Set Directory (ZIP, 1.03 MB) 2021 Child Core Set Non-HEDIS Value Set Directory (ZIP, 210.13 KB) 2021 Child Core Set Measurement Periods (PDF, 171.77 KB) 2021 Core Set Data Quality Checklist (PDF, 793.61 KB) Technical Assistance Resource: Calculating State-Level Rates UsingData
EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENTSEE MORE ONMEDICAID.GOV
FOSTER CARE LEARNING COLLABORATIVE: IMPROVING TIMELY Children and youth eligible for Title IV-E foster care payments are automatically eligible for Medicaid. While they represent less than 2 percent of all children enrolled in Medicaid, children and youth in foster care are an especially vulnerable population whose safety and well-being are the legal responsibility of the state, specifically the Medicaid and child welfare agencies. MBES/CBES WARNING PAGE MBES/CBES Warning Page. **WARNING**WARNING**WARNING**. UNAUTHORIZED ACCESS TO THIS COMPUTER IS PROHIBITED BY LAW (REFERENCE TITLE 18 U.S.C., SECTION 1030). This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Govermnent system, whichincludes
MEDICAID | MEDICAID
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government. CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) 9.6 Million Children Enrolled*. The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government. NEW FAQS – RELEASED JANUARY 6, 2021 NEW FAQs – Released January 6, 2021. 2 . waivers.” There are different kinds of 1135 waivers, including Medicare blanket waivers. When there is an emergency, sections 1135 or 1812(f) of the Act allow the Secretary to issue blanket ANNUAL MEDICAID & CHIP EXPENDITURES The federal government and states jointly fund and administer Medicaid and the Children’s Health Insurance Program (CHIP). The following data present a snapshot of recent annual expenditure statistics, such as expenditures by service category and state. Data are the most recent available, but reporting periods differ by source. TRANSFORMED MEDICAID STATISTICAL INFORMATION SYSTEM (T With the on-going changes to the national health care environment, the Centers for Medicare & Medicaid Services (CMS) has made significant investments to meet the organizational and information technology (IT) infrastructure to adequately represent CMS’ role in the healthcare marketplace. The Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systemsHOSPICE PAYMENTS
Payment for hospice services is made to a designated hospice provider based on the Medicaid hospice rates published annually in a memorandum issued by the Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services. These Medicaid hospice rates are effective from October 1 of each year through September 30 of thefollowing year.
UNITED STATES VIRGIN ISLANDS The United States Virgin Islands Medicaid delivery system is a subset of the larger public government healthcare delivery system for most of the island’s population. The United States Virgin Islands Department of Human Services is the single state agency. Through section 1108 of the Social Security Act (SSA), each territory is provided base MAGI 2.0: BUILDING MAGI KNOWLEDGE PART 2 8 A child’s income is excluded from total household income if: 1 The child is either under age 19* *At state option, includes children aged 19 or 20 who are full -time studentsWWW.MEDICAID.GOV
[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":" \u003Cdiv class=\u0022addthis_toolbox addthis_default_style addthis_16x16_style\u0022 APPENDIX K: EMERGENCY PREPAREDNESS AND RESPONSE Complete for each service added during a time of emergency. For services in the approved waiver which the state is temporarily modifying, enter the entire service definition and highlight thechange.
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------------------------- CORONAVIRUS DISEASE 2019 (COVID-19) The U.S. Department of Health and Human Services (HHS) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus named “Coronavirus Disease 2019” (abbreviated“COVID-19”).
Outbreaks of novel virus infections among people are always of public health concern. This is an ongoing situation and we will continue toupdate.
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