Medicaid
Medicaid is a joint federal-state program providing coverage for eligible low-income individuals and families, with requirements that vary by state.
Who it serves
Eligible low-income individuals, families, older adults and people with disabilities.
Key points
What providers should know about Medicaid.
Supporting Medicaid providers
Reflect state-specific eligibility and service requirements
Keep person-centred plans and consent records organised
Maintain an auditable record for state Medicaid reviews
Sectors, agencies & frameworks
The care sectors, federal agencies and regulatory frameworks most connected to Medicaid. Applicability varies by provider type, program and jurisdiction.
Regulatory frameworks
- CoPs — Federal standards providers must meet to participate in Medicare/Medicaid.
- AKS — Prohibits remuneration for referrals of federally funded care.
- FCA — Liability for false or fraudulent federal healthcare claims.
- 1557 — Non-discrimination in health programs and activities.
Many programmes — Medicaid and CHIP especially — vary state by state. CareFocusIQ is designed to reflect state licensing, staffing and programme requirements across all 50 states. Explore the 50-state directory for state-level intelligence.
Explore other federal programs
One platform, from federal program to the front line
CareFocusIQ connects agencies, programs, states and sectors into a single intelligent platform for US care.
CareFocusIQ provides technology and intelligence to support care operations and compliance. It is not a medical device and does not provide legal advice. Regulatory requirements vary by provider type, program and jurisdiction, and remain the responsibility of each provider.