Assistance Listings Grants to States for Medicaid
Overview
Objectives
To provide financial assistance to States for payments of medical assistance on behalf of cash assistance recipients, children, pregnant women, and the aged who meet income and resource requirements, and other categorically-eligible groups. In certain States that elect to provide such coverage, medically-needy persons, who, except for income and resources, would be eligible for cash assistance, may be eligible for medical assistance payments under this program. Financial assistance is provided to States to pay for Medicare premiums, copayments and deductibles of qualified Medicare beneficiaries meeting certain income requirements. More limited financial assistance is available for certain Medicare beneficiaries with higher incomes.
Examples of Funded Projects
Not Applicable.
Financial Information
| Obligation(s) | FY 23 | FY 24 (est.) | FY 25 (est.) |
|---|---|---|---|
| Formula Grants (Apportionments) Total | $665,383,468,000 | $689,565,730,000 | $697,770,025,000 |
| Totals | $665,383,468,000 | $689,565,730,000 | $697,770,025,000 |
Range and Average of Financial Assistance
$18,426,000 TO $59,200,006,000. Average assistance is $7,638,304,000
Accomplishments
Not Applicable.
Account Identification
75-0512-0-1-551
Criteria for Applying
Types of Assistance
A - Formula Grants (Apportionments)
Credentials and Documentation
Federal funds must go to a designated State Medicaid Agency. Individuals must meet State requirements. 2 CFR 200, Subpart E - Cost Principles applies to this program.
Applicant Eligibility
Designations
State (includes District of Columbia, public institutions of higher education and hospitals), Local (includes State-designated lndian Tribes, excludes institutions of higher education and hospitalsState and local welfare agencies must operate under an HHS-approved Medicaid State Plan and comply with all Federal regulations governing aid and medical assistance to the needy.
Beneficiary Eligibility
Designations
Individual/Family, Disabled (e.g. Deaf, Blind, Physically Disabled), Physically Afflicted (e.g. TB, Arthritis, Heart Disease), Mentally Disabled, Child (6-15), Youth (16-21), Senior Citizen (60+)Low-income persons who are over age 65, blind or disabled, members of families with dependent children, low- income children and pregnant women, certain Medicare beneficiaries and, in many States, medically-needy individuals may apply to a State or local welfare agency for medical assistance. At the State's option, eligibility to non-elderly individuals with family incomes up to 133 percent of the federal poverty level will start in calendar year 2014. Eligibility is determined by the State in accordance with Federal regulations.
Length and Time Phasing of Assistance
The needy receive medical assistance as necessary. States receive funds quarterly. The Electronic Transfer System will be used by States for monthly cash draws on the Federal Reserve Bank. Method of awarding/releasing assistance: lump sum
Use of Assistance
Designations
Health/Medical, Income Security/Social Service/WelfareFor the categorically needy, States must provide in and out-patient hospital services; rural health clinic services; federally-qualified health center services; other laboratory and x-ray services; nursing facility services, home health services for persons over age 21; family planning services; physicians' services; early and periodic screening, diagnosis, and treatment for individuals under age 21; pediatric or family nurse practitioner services; and services furnished by a nurse-midwife as licensed by the States. For the medically needy, States are required to provide a minimum mix of services for which Federal financial participation is available (see section 1902(a)(10)(C)(iv) of the Social Security Act).
Applying for Assistance
Deadlines
An individual needing medical assistance may apply to the State at any time. States must submit quarterly estimates of funds needed no later than August 8, November 15, February 15, and May 15, in order to receive a timely quarterly grant award for the following quarter.
Preapplication Coordination
Preapplication coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372. N/A
Application Procedures
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. Individuals needing medical assistance should apply directly to the State or local welfare agency. States should contact the Regional Administrator, CMS for application forms. (See Appendix IV of the Catalog for agency Regional Office addresses.)
Criteria for Selecting Proposals
Award Procedure
States are awarded funds quarterly based on their estimates of funds needed to provide medical assistance to the needy. Awards are made quarterly on a fiscal year basis as follows: October 1, January 1, April 1, and July 1. Individuals receive medical care from providers of medical care who are participating in the Medicaid program.
Date Range for Approval/Disapproval
Up to 60 days. The States usually provide needy individuals with immediate medical assistance.
Renewals
Recipients receive assistance as long as they are qualified under State requirements.
Appeals
Individuals denied medical assistance by the State or local welfare agency must be given a fair hearing on appeal (see 42 CFR, Subchapter C, Part 431, Subpart E). States have 60 days to resubmit revised applications.
Compliance Requirements
Policy Requirements
Subpart B, General provisions
Subpart C, Pre-Federal Award Requirements and Contents of Federal Awards
Subpart D, Post Federal; Award Requirements
Subpart E, Cost Principles
Subpart F, Audit Requirements
Not Applicable
Additional Information:
Reports
Expenditure Reports: States must submit fiscal and statistical reports, as required, to the Centers for Medicare and Medicaid Services, Department of Health and Human Services. A Treasury Report TUS-5401 is required monthly. States must submit certified expenditure reports within 30 days after the end of each quarter.
Audits
https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-F
Records
States must maintain records which substantiate direct and indirect costs charged to the grant award activity.
Regulations, Guidelines, and Literature
42 CFR, Subchapter C.
Formula and Matching Requirements
Matching requirements are voluntary.
Contact Information
Regional or Local Locations:
See Regional Assistance Locations. Contact the Associate Regional Administrator, Division of Medicaid, Center for Medicaid, CHIP and Survey & Certification. (See Appendix IV of the Catalog for addresses and telephone numbers.).Headquarters Office:
7500 Security Boulevard,
Baltimore, MD 21244
sean.danus@cms.hhs.gov
(410) 786-3870.