State-by-State Medicaid Compliance

HeyMedicaid complies with federal Medicaid regulations and state-specific privacy laws. We work closely with state agencies to ensure our platform meets all local requirements for handling Medicaid beneficiary information.

Current Coverage: HeyMedicaid is currently available in 15 states, with expansion to all 50 states planned by Q4 2025. We comply with each state's unique Medicaid program requirements and privacy regulations.

1. Federal Medicaid Requirements

CMS Compliance Standards

42 CFR Part 431 - State Organization and General Administration
42 CFR Part 435 - Eligibility Verification Systems
42 CFR Part 438 - Managed Care Regulations
45 CFR Part 164 - HIPAA Security and Privacy

MITA 3.0 Maturity Standards
EVS (Eligibility Verification System) Integration
T-MSIS Data Reporting Requirements
Section 1115 Waiver Compliance

2. State-by-State Coverage

State	Status	Medicaid Program	Enrollees	Key Laws
California	Live	Medi-Cal	14.6M	CCPA/CPRA, CMIA, SB 1001
Texas	Live	Texas Medicaid	5.3M	HB 4390, Texas Medical Records Privacy Act
New York	Live	NY Medicaid	7.8M	SHIELD Act, Public Health Law Article 27-F
Florida	Coming Soon	Florida Medicaid	5.2M	FIPA, Florida Medical Records Act
Illinois	Coming Soon	Illinois Medicaid	3.4M	BIPA, Mental Health Records Act
Pennsylvania	Planned	Medical Assistance	3.1M	Act 112, Medical Records Act

3. Key State-Specific Requirements

California (Medi-Cal)

CCPA/CPRA compliance with "Do Not Sell" button
CMIA medical information protections
30-day response time for privacy requests
County-specific Medi-Cal managed care plans
Whole Person Care pilot participation

New York

SHIELD Act data security requirements
72-hour breach notification
NYC-specific health code compliance
Managed Long Term Care integration
DSRIP program participation

Texas

HB 4390 biometric data protections
Texas Medical Records Privacy Act
STAR managed care requirements
1115 Transformation Waiver compliance
Telehealth/telemedicine specific rules

Florida

FIPA consumer data privacy
Statewide Medicaid Managed Care program
Baker Act mental health provisions
Telehealth consent requirements
Hurricane emergency protocols

4. Nationwide Expansion Timeline

Phase 1: Currently Live (15 States)

Q4 2024 - Q1 2025

CA, NY, TX, FL, PA, IL, OH, GA, NC, MI, NJ, VA, WA, AZ, MA

Phase 2: Coming Soon (20 States)

Q2 2025

TN, IN, MO, MD, WI, CO, MN, SC, AL, LA, KY, OR, OK, CT, UT, IA, NV, AR, MS, KS

Phase 3: Full Coverage (15 States)

Q3-Q4 2025

NE, WV, ID, HI, NH, ME, MT, RI, DE, SD, ND, AK, VT, WY, DC

5. Regulatory Relationships

HeyMedicaid maintains active relationships with state Medicaid agencies, CMS regional offices, and state privacy regulators. We participate in state Medicaid IT governance committees and comply with all state-specific reporting requirements.

Monthly Reporting

To state agencies

Annual Audits

State compliance

Legal Updates

Continuous monitoring

Agency Meetings

Quarterly reviews

State Compliance Questions?

State Compliance Team

HeyMedicaid, Inc.
Attn: State Compliance
PO Box 1234
San Francisco, CA 94102

Direct Contact

Email: states@heymedicaid.com
Phone: 1-800-MEDICAID ext. 3
State Agencies: agency@heymedicaid.com
Regulatory Affairs: regulatory@heymedicaid.com

For State Agencies: Please contact our dedicated state liaison team at agency@heymedicaid.com for compliance documentation, audit reports, and regulatory inquiries. We maintain 24/7 support for state agency requests.