The Medicaid Law

Where can I find the Medicaid law?

Medicaid is a federal program that the states choose to participate in. As noted on CMS website:”On July 30, 1965, President Lyndon B. Johnson signed into law legislation that established the Medicare and Medicaid programs.”  Medicaid is codified as Title XIX of the Social Security Act. Its sections range from 1900 to 1946. It is found in the United States Code in sections 42 USC §§1396–1396v.

Regulations relating to Title XIX are contained in chapter IV, Title 42, and subtitle A, Title 45, Code of Federal Regulations.

CMS

“The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid . . . .”
From https://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services

State Medicaid Manual

CMS publishes the State Medicaid Manual as guidance to the states on implementation of their Medicaid programs. It may be found at https://www.cms.gov/regulations-and-guidance/guidance/manuals/paper-based-manuals-items/cms021927.html

Michigan Medicaid Enactment

States must choose to participate in Medicaid. Michigan’s Medicaid authorizing acts are found in the Social Welfare Act MCL 400.1 – 400.122. Note this codification arrangement is subject to change.

Michigan Medicaid State Plan

States participate in the program by submitting a State Medicaid Plan to CMS for approval. It is described as follows on the Michigan gov website:

“In accordance with Federal regulations at 42 CFR 430.10, the State Plan is a comprehensive written statement describing the nature and scope of the Michigan Medicaid program giving assurance that it will be administered in conformity with the specific requirements of Title XIX, all applicable Federal Regulations and other officials issuances regarding Medicaid as published by the U.S. Department of Health and Human Services (HHS).

The Michigan Medicaid State Plan is an agreement between the state and federal government that identifies the general health care services, reimbursement, and eligibility policies in effect under Michigan Medicaid. It is the basis for the federal government (CMS/HHS) to pay its federal financial participation (FFP) for the program’s operation. The plan is written on a more general level than contained in program policy.”

From https://www.michigan.gov/mdhhs/0,5885,7-339-71547_4860-225474–,00.html

The Michigan Medicaid State Plan is found at:
http://www.mdch.state.mi.us/dch-medicaid/manuals/MichiganStatePlan/MichiganStatePlan.pdf

Michigan Medicaid Administrative Policies

The Michigan Medicaid program “policies” are found in the Bridges Administrative Manual and the Bridges Eligibility Manual. The Bridges Policy Glossary defines terms used. These may be found at https://dhhs.michigan.gov/olmweb/ex/html/ .

Note the Michigan Medicaid program does not have administrative rules promulgated under the Michigan Administrative Procedures Act. That is because the assigned agency, the Department of Health and Human Services, does not interpret the Medicaid law, but rather it provides the program services under the rules and guidance of CMS.