The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing laws passed by Congress related to Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. To implement these programs, CMS issues various forms of guidance to explain how laws will be implemented and what states and others need to do to comply. In addition to regulations, CMS issues sub-regulatory guidance to address policy issues as well as operational updates and technical clarifications of existing guidance.
Federal Policy Guidance
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Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements (CMS 2482-P)
Date:
Topics:
- Prescription Drugs
- Eligibility
Type: Regulations
2020 Medicaid Federal Poverty Level Standards
Date:
Topics:
- Children's Health Insurance Program
- Eligibility
- Medicaid-Medicare Issues
- Program Administration
Type: Informational Bulletin
Access to Mental Health and Substance Use Disorder Services for Children and Pregnant Women in the Children’s Health Insurance Program
Date:
Topics:
- Children's Health Insurance Program
- Eligibility
- Program Administration
Type: State Health Official Letter
New Extension of the Affordable Care Act’s Spousal Impoverishment Provision for Married Applicants and Recipients of Home and Community-Based Services
Date:
Topics:
- Eligibility
Type: Informational Bulletin
Basic Health Program Funding Methodology Proposed Payment Notice for Program Year 2021
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
- Basic Health Program
Type: Regulations
2020 SSI and Spousal Impoverishment Standards
Date:
Topics:
- Eligibility
Type: Informational Bulletin
CIB: 2020 Updates to the Adult and Child Core Health Care Quality Measurement Sets
Date:
Topics:
- Children's Health Insurance Program
- CHIPRA
- Program Administration
- Quality of Care
Type: Informational Bulletin
Further Guidance to Medicaid Bipartisan Budget Act (BBA) of 2018 and changes to Medicaid Provisions Passed in April 2019 – Third Party Liability in Medicaid and CHIP
Date:
Topics:
- Eligibility
- Financing & Reimbursement
Type: Informational Bulletin
Medicare-Medicaid Integration and Unified Appeals and Grievance Requirements for State Medicaid Agency Contracts with Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) for Contract Year 2021
Date:
Topics:
- Eligibility
- Medicaid-Medicare Issues
Type: Informational Bulletin
Basic Health Program Funding Methodology Final Notice for Program Years 2019 and 2020
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
- Basic Health Program
Type: Regulations