Medicaid-State Health Plan

[Guest S Craig]

As Medicaid is administered by State governments and not Federal, is this referred to by HIPAA as the "State Health Plan?"

The reason for asking is that our state program (Maine), although it is considered creditable coverage for PEC purposes, is not presently issuing certificates of creditable coverage, as I believe it is compelled to do by HIPAA. (Is it compelled to do so?)

This has begun to cause problems for some clients with large claims dollars, as upon the claims audit, they have not been able to provide proof of prior coverage if Medicaid was their prior insurance.

Any thoughts?