Health administration and policy 3

Medicaid and CHIP Medicaid and CHIP What is Medicaid:

http://www.youtube.com/watch?v=NZJ-k0uLx0A Medicaid ● State/Federal partnership program providing care to low income Americans Medicaid’s Role in Financing ● Safety-Net Providers ○ DSH Payments ● LTSS Structure of Medicaid ● State/Federal Partnership ● States Administer Medicaid ○ State Plan and SPAs ● Federal Waivers Who Medicaid Covers ○ Children ○ Low Income Parents ○ Pregnant Women ○ Elderly ○ Disabled (ABD population) Children ● Low income ● Wards of the State CHIP ● Created in 1997 ● Covers children at higher incomes than Medicaid ● Higher FMAP Pregnant Women & Low Income Parents ABD ● Disabled Individuals ● Dual Eligibles ● http://www.youtube.com/watch?v=6PMyIykSMCU What is Covered?

Mandatory Services ● Physician’s Services ● Hospital Services (inpatient and outpatient) ● Lab and x-ray services ● EPSDT ● FQHC and RHC services ● Family planning services and supplies ● Pediatric and family nurse practitioner, nurse midwife services ● SNF ● Home Health Care for persons eligible for SNF ● Transportation ● Optional Services “Skin in the Game” ● Premiums ● Cost Sharing Managed Care and Medicaid ● MCO ● PCCM ● Expansion: http://www.nebraskalegislature.gov/bills/view_bill.php?

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