Medicaid Health Care Finance - Essay Example

Medicaid is obtainable only to certain low-income individuals and families who fit into an eligibility cluster that is recognized by federal and state law. Medicaid does not disburse money to a person instead, it sends payments straight to the person's health care provider (Heiser, 2008). Depending on the state's rules, a person may also be asked to compensate a small division of the charge for a few medical services. Medicaid is a state-administered plan and each state sets its individual guidelines regarding eligibility and services.

Many groups of people are roofed by Medicaid, even within these groups, though, definite requirements must be met. These may comprise age, pregnancy, disability, blindness, or old age, income, and resources, and if a person is a U.S. citizen or a lawfully admitted immigrant. The regulations for counting income and resources differ from state to state and from group to group. There are particular rules for those who reside in nursing homes and for disabled children living at home (Commerce Clearing House, 2007).

A child may be entitled to coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if his or her parents are not. Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with a person, the child may be qualified even if that person is not because the earnings and resources will not add up for the child. Fraud and abuse Centers for Medicare & Medicaid Services CMS are dedicated to fighting fraud and abuse, which redirect dollars that could or else be spent to preserve the health and welfare of Medicaid customers.

To fortify its obligation, CMS has implemented a Medicaid veracity module. This is in reply to the requirements of the Deficit Reduction Act DRA of 2005, finalized on February 8, 2006, by the President, in which Congress proposed CMS to establish the Medicaid Integrity Program MIP. In doing so, it spectacularly augmented the resources accessible to CMS to fight fraud, misuse, and exploitation in the Medicaid program. The DRA says that a five-year Comprehensive Medicaid Integrity Plan CMIP be printed to guide MIP growth and functions.