LibGuides: Medicare and Medicaid Research: Primary Sources: State

Statutes and Regulations

California statutes:
Most (but not all) of the relevant statutes are in the Welfare & Institutions Code (the basic Medi-Cal statute starts at Welfare & Institutions Code Section 14000), the Business & Professions Code, or the Health & Safety Code.
Library: West’s Annotated California Codes KFC 30.5 W4 (Reference Reading Room and second floor)
Internet: California Legislative Information (Non-annotated version of the California Codes)
California Code of Regulations (CCR)
Most (but not all) of the relevant regulations will be Titles 22 and 16.
Library: KFC35 1990 .A2 (Second floor)
Internet: California Office of Administrative Law
The California Office of Administrative Law, California Regulatory Notice Register (AKA “The Z-Register”
This is where new regulations are published before being incorporated into the CCR.

Case Law

A full discussion of how to research case law is beyond the scope of this Guide. Please see these UCLA Law Library LibGuides

California Case Materials Checklist

State Plan and Medicaid Waivers

STATE PLAN AND MEDICAID WAIVERS State Plan
This is the contract between the state and CMS which explains how the state will implement its own Medicaid program. Many states make them available on their state health care services agency website

Waivers or demonstration programs: CMS has the authority, through certain parts of the SSA, to waive some Medicaid requirements. If a state requests a waiver, it must go through a process with CMS during which it describes what the demonstration project is, what its goals are, and how those goals will be measured. CMS has some documentation for some of these waiver projects available on its website. Approach the CMS database with caution, however. It is incomplete, and full of broken links.

As required by the Patient Protection and Affordable Care Act (PPACA), the process to obtain a waiver under Section 1115 of the SSA has become more transparent. More information about this change in rules is available below:

Review and Approval Process for Section 1115 Medicaid Demonstrations--Final Rule
42 CFR Part 431, effective April 27, 2012
Letter from CMS to State Medicaid Directors about the Revised 1115 Process
Public User Guide to the Medicaid.gov Section 1115 Demonstration Page
Guide to help members of the public make comments on pending demonstration applications.

Sub-regulatory Guidance

From CMS, often in the form of Medicaid State Director Letters and State Health Official Letters. These letters and other Medicaid federal policy materials can be found on Medicaid.gov.

Federal policy materials can be found on Medicaid.gov

From the state agency or agencies involved in administering the state’s Medicaid program, or which interact with the Medicaid program, in the form of forms, manuals, letters, FAQs, press releases, etc.

The readily researchable material will vary wildly from state to state. Also, note that you may have to do some digging, and some site searching with keywords to find the materials you need, as materials may not always be logically categorized.

Helpful links from the California Department of Health Care Services:

Helpful links from the California Department of Public Health (this agency is responsible for the licensure of health care facilities):

Helpful links from the California Department of Developmental Services: