This amendment amend the Supplement to Attachment 4.22, which provides an attestation that state laws are in place that restrict third party insurers from denying a claim solely on the basis that the Medicaid member failed to obtain prior authorization for a service so long as that service is covered in the state plan or a waiver.
Due to the government shutdown, updates to information on this website may be limited or delayed. State Medicaid and Children’s Health Insurance Programs (CHIP) continue to operate. Continue to work with the programs in your state to access coverage. For more information about government operating status, visit OPM.gov.