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Medicaid - Overview

Title XIX of the Social Security Act is a Federal-State matching entitlement program that pays for medical assistance for certain vulnerable and needy individuals and families with low incomes and resources. This program, known as Medicaid, became law in 1965 as a jointly funded cooperative venture between the Federal and State governments ("State" used herein includes the Territories and the District of Columbia) to assist States furnishing medical assistance to eligible needy persons. Medicaid is the largest source of funding for medical and health-related services for America's poorest people. In FY 2001, it provided health care assistance to more than 46 million persons. In FY 2003, direct payments to providers were $197.3 billion, and total outlays for the program (Federal and State) were $278.3 billion.

Within broad national guidelines established by Federal statutes, regulations and policies, each State: (1) establishes its own eligibility standards; (2) determines the type, amount, duration, and scope of services; (3) sets the rate of payment for services; and (4) administers its own program. Medicaid policies for eligibility, services, and payment are complex, and vary considerably even among similar-sized and/or adjacent States. Thus, a person who is eligible for Medicaid in one State might not be eligible in another State; and the services provided by one State may differ considerably in amount, duration, or scope from services provided in a similar or neighboring State. In addition, Medicaid eligibility and/or services within a State can change during the year.

NOTE: Medicaid data are based on the projections of the Mid-session Review of the President's Fiscal Year 2005 Budget and are consistent with data received from the States.

Much of the material in this and the related topics below is drawn from a HCFA (now CMS) report prepared by Mary Onnis Waid entitled "Brief Summaries of Medicare and Medicaid", dated June 25, 1998, and updated periodically. These topics are based on the latest revision, available at:
http://www.cms.hhs.gov/MedicareProgramRatesStats/02_SummaryMedicareMedicaid.asp

See these topics for additional information:

·   Medicaid - Eligibility

·   Medicaid - Scope of Services

·   Medicaid - Amount and Duration of Services

·   Medicaid - Payment for Services

·   Medicaid - Data Summary and Trends

·   Relationship of Medicaid and Medicare

Source

http://www.cms.hhs.gov/MedicareProgramRatesStats/02_SummaryMedicareMedicaid.asp

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