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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Best Practices for Adhering to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Requirements
Date:
Topics:
- Access to Care
- Benefits
- Children's Health Insurance Program
- Coverage
- Delivery Systems
- Managed Care
- Outreach & Enrollment
- Program Administration
- COVID-19
Type: State Health Official Letter
Medicaid and CHIP Managed Care Monitoring and Oversight Tools, including States’ Responsibility to Comply with Medicaid Managed Care and Separate CHIP Mental Health and Substance Use Disorder Parity Requirements
Date:
Topics:
- Managed Care
- Children's Health Insurance Program
- Mental Health
- Substance Use Disorders
Type: Informational Bulletin
Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality (CMS-2439-F)
Date:
Topics:
- Children's Health Insurance Program
- Delivery System
- Managed Care
- Program Administration
Type: Regulations
Medicaid and CHIP Managed Care Monitoring and Oversight Tools #3
Date:
Topics:
- Managed Care
- Program Integrity
- Children's Health Insurance Program
Type: Informational Bulletin
State Guidance on Claiming Methodologies for Medicaid Managed Care (SMD 23-005)
Date:
Topics:
- Financing & Reimbursement
- Managed Care
Type: State Medicaid Director Letter
Mandatory Medicaid and Children’s Health Insurance Program Coverage of Adult Vaccinations under the Inflation Reduction Act
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Cost Sharing
- Financing & Reimbursement
- Managed Care
- Reimbursement
- COVID-19
Type: State Health Official Letter
Additional Guidance on Use of In Lieu of Services and Settings in Medicaid Managed Care (SMD 23-001)
Date:
Topics:
- Benefits
- Financing & Reimbursement
- Managed Care
Type: State Medicaid Director Letter
Links:
Leveraging Medicaid, CHIP and Other Federal Programs in the Delivery of Behavioral Health Services for Children and Youth
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
- COVID-19
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
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