Medicaid: Access, Program Integrity and Improvements Needed

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The Centers for Medicare & Medicaid Services (CMS)—a federal agency within the Department of Health and Human Services (HHS)—and states jointly administer and fund the Medicaid program. States have flexibility within broad federal requirements to design and implement their Medicaid programs. States must submit a state Medicaid plan to CMS for review and approval. A state’s approved Medicaid plan outlines the services provided and the groups of individuals covered. While states must cover certain mandatory populations and benefits, they have the option of covering other categories of individuals and benefits. (Imprint: SNOVA)

Chapter 1. Medicaid: Access to Health Care for Low-Income Adults in States with and without Expanded Eligibility

Chapter 2. Medicaid: Actions Needed to Mitigate Billions in Improper Payments and Program Integrity Risks
Statement of Gene L. Dodaro

Chapter 3. Medicaid: CMS Has Taken Steps to Address Program Risks but Further Actions Needed to Strengthen Program Integrity

Chapter 4. Medicaid: CMS Needs to Better Target Risks to Improve Oversight of Expenditures

Chapter 5. Medicaid Managed Care: Improvements Needed to Better Oversee Payment Risks

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