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Medicaid is a federal-state partnership.

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States run their programs, but they must follow federal law

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and an approved state plan.

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CMS is the federal anchor: it reviews state plans and waivers,

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issues program requirements and guidance,

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monitors performance, and can require corrective action.

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That does not mean CMS decides every individual service dispute,

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enforces every civil-rights claim, or validates every complaint.

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HHS's Office for Civil Rights has a separate civil-rights role, while states

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handle eligibility, authorizations, providers, notices, and appeals.

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To make oversight possible, save the approved plan or waiver,

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service authorization, notices, appeal decisions,

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accessibility requests, claims data, and agency responses.

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A complaint is a lead, not a finding;

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speech is not an audit;

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an improper payment is not proof of fraud.

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Read the source-linked record at david-medeiros.com.