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Medicaid State Plan

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Last Updated: January 14, 2026

Section 1: Single State Agency Organization

Section 2: Coverage and Eligibility

Section 2: MMDL and MACPro System Approvals

Eligibility

Medicaid and CHIP Program (MACPro)

Medicaid Modified Adjusted Gross Income (MAGI) Eligibility

Section 3: Services - General Populations

Section 3 - Service Provisions
- Attachment 3.1A Amount Duration and Scope of Services for Categorically Needy - SPA Updated 01/2026
  - Supplement
  - Supplement - Targeted Case Management
  - Supplement - PACE
  - Supplement - Medication-Assisted Treatment - SPA Updated 01/2026
- Attachment 3.1B - Amount, Duration and Scope of Services Provided to Medically Needy Groups - SPA Updated 01/2026
  - Supplement - Medication-Assisted Treatment - SPA Updated 01/2026
- Attachment 3.1D - Methods of Providing Transportation
- Attachment 3.1E - Standards for Coverage of Organ Transplants
- Attachment 3.1F - Managed Care - SPA Updated 01/2025
- Attachment 3.1G - Alternative Benefits
Section 3.2 - Coordination of Medicaid with Medicare and Other Insurance
- Attachment 3.2A - Coordination of Medicare

Section 3: MMDL System Approvals

Alternative Benefit Plan (ABP)

Supports and Training for Employing People Successfully (STEPS)

Working Healthy

Section 4: General Program Administration

Section 4.1 - General Program Administration SPA Updated 012025
Section 4.11 - Relations with Standards-Setting and Survey Agencies
- Attachment 4.11a - Standards-Setting Authority for Institutions
Section 4.14 Utilization Control
- Attachment 4.14b - Utilization Review Methods for Intermediate Care Facilities
Section 4.16 - Relations with State Health and Vocational Rehabilitation Agencies and Title V Grantees
- Attachment 4.16a - Cooperative Arrangements with State Health and State Vocational Rehabilitation Agencies with Title V Grantees.
Section 4.17 - Liens and Adjustments or Recoveries
- Attachment 4.17a - Liens and Adjustments or Recoveries
Section 4.18 - Medicaid Premiums and Cost Sharing
Section 4.19 - Payments for Services
- Attachment 4.19a - Inpatient Hospital Care - SPA Updated 01/2026
  - Attachment A1 - Psychiatric Residential Treatment Facilities
  - Attachment A2 - Psychiatric Residential Treatment Facilities
- Attachment 4.19b - Outpatient Hospital Care - SPA Updated 01/2026
  - Supplement 1 - Payment of Medicare A, B, C Deductibles, Coinsurance
  - Supplement 2 - 1905(a)(29) Medication-Assisted Treatment - SPA Updated 01/2026
- Attachment 4.19c - Method of Payment for Reserving Beds During a Recipients Absence from an Inpatient Facility
- Attachment 4.19d Part I - Payments for Skilled Nursing Facilities
- Attachment 4.19d Part II - Payments for Intermediate Care Facilities
- Attachment 4.19e - Definition of Claims
Section 4.22 - Third Party Liability
Section 4.24 - Standards for Payments for Skilling Nursing and Intermediate Care Facility Services
- Attachment 4.24 Part I
- Attachment 4.24 Part II
Section 4.30 - Exclusion of Providers and Suspension of Practitioners and Other Individuals
Section 4.32 - Income and Eligibility Verification System
- Attachment 4.32a - Income and Eligibility Verification System Procedures - Requests to Other State Agencies
Section 4.33 - Medicaid Eligibility Cards for Homeless Individuals
- Attachment 4.33a - Method for Issuance of Medicaid Eligibility Cards to Homeless Individuals
Section 4.34 - Systematic Alien Verification for Entitlements
- Attachment 4.34a - Requirements for Advance Directives
Section 4.35 - Enforcement of Compliance for Nursing Homes
Section 4.38 - Nurse Aide Training and Competency Evaluation for Nursing Facilities
- Attachment 4.38 - Disclosure of Additional Registry Information
- Attachment 4.38a - Collection of Additional Registry Information
Section 4.39 - Pre-admission Screening and Annual Resident Review in Nursing Facilities
- Attachment 4.39 - Definition of Specialized Services
Section 4.40
Section 4.42 - Employee Education About False Claim Recoveries
- Attachment 4.42a - Method of Compliance Oversight and Frequency with which the State will Reassess Compliance

Section 5: Personnel Administration

Section 6: Financial Administration

Section 7: General Provisions