Medicaid State home care plans are authorized under two provisions of the Social Security
Act. Section 1915(c) authorizes the Secretary to allow States, under home and community
based services programs, to provide services not normally covered under the State
plan to individuals in the community who otherwise would be in an institution if those
services were not available. For Medicaid purposes, the deeming rules are waived under
Section 1902(e)(3) allows a State to amend its State plan to include some disabled
children age 18 or younger living at home who would be eligible for Medicaid if in
a medical institution. These children are considered to be SSI recipients for purposes
of Medicaid entitlement.
Each State administers its own Medicaid program. Although home care plans authorized
under section 1915(c) require CMS central office approval, each State develops its
own plan(s) and methods of administering them. Currently, 46 States have some form
of waiver allowing medical assistance for care of individuals at home.