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
REFINE YOUR SEARCH:
Protecting Medicaid Beneficiaries Against Impermissible Fraud and Abuse Sanctions (SMD 24-005)
Date:
Topics:
- Access to Care
- Compliance
- Program Administration
- Program Integrity
Type: State Medicaid Director Letter
Links:
CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Date:
Topics:
- Tribal Issues
- Benefits
Type:
Medicaid and CHIP Managed Care Monitoring and Oversight Tools #3
Date:
Topics:
- Managed Care
- Program Integrity
- Children's Health Insurance Program
Type: Informational Bulletin
Further Extension of Grace Period Related to the “Four Walls” Requirement under 42 C.F.R. § 440.90 for Indian Health Service and Tribal Facilities to February 11, 2025
Date:
Topics:
- Tribal Issues
- COVID-19
- Unwinding
Type: Informational Bulletin
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
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
Further Extension of Grace Period Related to the “Four Walls” Requirement under 42 C.F.R. § 440.90 for Indian Health Service and Tribal Facilities to Nine Months after the COVID-19 PHE Ends
Date:
Topics:
- Tribal Issues
- COVID-19
Type: Informational Bulletin
Third Party Liability in Medicaid: State Compliance with Changes Required in Bipartisan Budget Act of 2018 and Medicaid Services Investment and Accountability Act of 2019
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Cost Sharing
- Data & Systems
- Delivery System
- Eligibility
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
- Outreach & Enrollment
- Program Administration
- Program Integrity
Type: Informational Bulletin
Medicaid Program: Reassignment of Medicaid Provider Claims (CMS-2444-P)
Date:
Topics:
- Financing & Reimbursement
- Long-Term Services & Support
- Program Administration
- Program Integrity
- Quality of Care
Type: Regulations
Medicaid and CHIP Managed Care Monitoring and Oversight Tools
Date:
Topics:
- Children's Health Insurance Program
- Managed Care
- Program Integrity
- Quality of Care
- Delivery System
Type: Informational Bulletin