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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Beneficiary Protections and Medicaid Drug Coverage - Under Value Based Purchasing (VBP) and Other Innovative Payment Arrangements
Date:
Topics:
- Prescription Drugs
Type: Informational Bulletin
Home and Community-Based Services Quality Measure Set (SMD 22-003)
Date:
Topics:
- Long-Term Services & Support
- Quality of Care
Type: State Medicaid Director Letter
Medicaid and CHIP Managed Care Monitoring and Oversight Tools #2
Date:
Topics:
- Children's Health Insurance Program
- Managed Care
- Program Integrity
- Quality of Care
- Delivery System
Type: Informational Bulletin
Updated Reporting Requirements and Extension of Deadline to Fully Expend State Funds Under American Rescue Plan Act of 2021 Section 9817 (SMD 22-002)
Date:
Topics:
- Benefits
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
Type: State Medicaid Director Letter
Updated 2022 SSI and Spousal Impoverishment Standards
Date:
Topics:
- Eligibility
Type: Informational Bulletin
Basic Health Program: Proposed Federal Funding Methodology for Program Year 2023 and Proposed Changes to Basic Health Program Regulations
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
Type: Regulations
Medicaid and CHIP Coverage of Stand-alone Vaccine Counseling
Date:
Topics:
- Benefits
- Children's Health Insurance Program
Type: State Health Official Letter
Medicaid Program: Reassignment of Medicaid Provider Claims Final Rule (CMS-2444-F)
Date:
Topics:
- Financing & Reimbursement
- Long-Term Services & Support
- Program Administration
- Program Integrity
- Quality of Care
Type: Regulations
Updated Medicaid Information Technology Systems Guidance: Streamlined Modular
Certification for Medicaid Enterprise Systems
Certification for Medicaid Enterprise Systems
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
CMS Enforcement Discretion – Medicaid Access Monitoring Review Plans
Date:
Topics:
- Program Administration
Type: Informational Bulletin