Family Planning Services Claimed by Ohio From October 1, 2007, Through September 30, 2009

摘要

Pursuant to Title XIX of the Social Security Act (the Act), the Medicaid program provides medical assistance to low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer the Medicaid program. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) administers the Medicaid program. Each State administers its Medicaid program in accordance with a CMS-approved State plan. Although the State has considerable flexibility in designing and operating its Medicaid program, it must comply with applicable Federal requirements. In Ohio, the Department of Job and Family Services (State agency) administers the Medicaid program and is responsible for providing family planning services and reporting expenditures for Federal reimbursement. The amount of funding that the Federal Government reimburses to State Medicaid agencies, known as either Federal financial participation (FFP) or Federal share, is determined by the Federal medical assistance percentage (FMAP), which varies based on a States relative per capita income. The State agencys FMAP ranged from 60.79-percent to 72.34-percent for claims paid from October 1, 2007, through September 30, 2009. Federal requirements also make provisions for various specified services to be reimbursed at higher rates of FFP. Section 1903(a)(5) of the Act and 42 CFR SC 433.10(c)(1) authorize reimbursement at an enhanced 90-percent FFP rate for family planning services. Section 4270 of the CMS State Medicaid Manual (the manual) states that family planning services include those that prevent or delay pregnancy or otherwise control family size and may include infertility treatments. Pursuant to the provisions of the manual, only items and procedures clearly furnished or provided for family planning purposes may be claimed at the enhanced 90-percent FFP rate.