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COMBINED MEDICAID 0-3 Introduction Supersedes: FMA 0-3, (01/01/06) and MA 0-3 (09/01/98) Reference: 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. Medicaid became law in 1965 as a jointly funded cooperative venture between the federal and state governments to assist states furnishing medical assistance to eligible needy individuals. Medicaid is the largest program funding medical and health-related services for America’s poorest people. 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 payment rate for services; and 4. Administers its own program. Medicaid policies for eligibility and services are complex, and vary considerably even among similar- sized and/or adjacent states. Thus, a person who is eligible for Medicaid in Montana may not be eligible in another state; and the services provided in Montana may differ considerably in amount, duration, or scope from services provided in neighboring states. In addition, Medicaid eligibility and/or services within a state can change during the year. RESPONSIBILITY FOR PROGRAM ADMINISTRATION: Medicaid is administered in joint cooperation by Federal and State governments. This is accomplished cooperatively with the Field Offices of Public Assistance and processing centers providing the day-to-day client contact under state policies. The Federal government provides guidelines for state operations. USING THIS MANUAL: The policies in this manual are intended as a guide for eligibility determination and are written within the Centers for Medicare and Medicaid Services (CMS) imposed limits. The policies are intended to be sufficiently flexible to allow eligibility staff to exercise reasonable judgment in processing Medicaid eligibility.