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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Eligibility for 90 percent Federal matching funds for health information exchange activities
Date:
Topics:
- Data & Systems
Type: Frequently Asked Questions
Shared Savings Methodologies
Date:
Topics:
- Financing & Reimbursement
- Long-Term Services & Support
Type: State Medicaid Director Letter
Links:
Transformed Medicaid Statistical Information System (T-MSIS) Data
Date:
Topics:
- Data & Systems
- Managed Care
- Program Administration
- Program Integrity
Type: State Medicaid Director Letter
Eligibility Reviews Under PERM and MEQC
Date:
Topics:
- Affordable Care Act (ACA)
- Eligibility
- Program Integrity
Type: Informational Bulletin
Payment Error Rate Measurement (PERM) eligibility reviews, Medicaid Eligibility Quality Control (MEQC) Program, and development of an interim approach for assessing payment error for eligibility
Date:
Topics:
- Affordable Care Act (ACA)
- Eligibility
- Program Integrity
Type: State Health Official Letter
CMS Answers to Frequently Asked Questions:Telephonic Applications, Medicaid and CHIP Eligibility Policy and 75/25 Federal Matching Rate
Date:
Topics:
- Children's Health Insurance Program
- Eligibility
- Financing & Reimbursement
- Program Administration
- Affordable Care Act (ACA)
Type: Frequently Asked Questions
Medicare Competitive Bidding Program for Durable Medical Equipment and Coordination of Benefits for Dual Eligibles
Date:
Topics:
- Medicaid-Medicare Issues
Type: Informational Bulletin
Targeting Medicaid Super-Utilizers to Decrease Costs and Improve Quality
Date:
Topics:
- Delivery System
- Program Administration
- Quality of Care
Type: Informational Bulletin
Tri-Agency Letter on Trauma-Informed Treatment
Date:
Topics:
- Benefits
- Program Administration
- Quality of Care
Type: State Medicaid Director Letter
Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment (CMS-2334-F)
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Cost Sharing
- Eligibility
Type: Regulations