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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Opportunities to Improve HIV Testing, Prevention, and Care Delivery for Medicaid and CHIP Beneficiaries
Date:
Topics:
- Access to Care
- Coverage
- Prescription Drugs
Type: Informational Bulletin
Section 5112 Requirement for all States to Provide Continuous Eligibility to Children in Medicaid and CHIP under the Consolidated Appropriations Act, 2023: Updated SHO and FAQs
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Coverage
- Eligibility
- Program Administration
- COVID-19
- Unwinding
Type: State Health Official Letter
Ensuring Seamless Coverage Transitions between Medicaid, Separate CHIP, and Other Insurance Affordability Programs and Exercise of Enforcement Discretion to Delay Implementation of Certain Coverage Transition Requirements
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Compliance
- Coverage
- Eligibility
- Enrollment
- Program Administration
- Renewals
- Unwinding
- COVID-19
Type: Informational Bulletin
Medicaid and Children’s Health Insurance Program Requirements for Providing, Prepopulating and Accepting Eligibility Renewal Forms
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Coverage
- Eligibility
- Enrollment
- Program Administration
- Renewals
- Unwinding
Type: Informational Bulletin
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:
Basic Requirements for Conducting Ex Parte Renewals of Medicaid and CHIP Eligibility
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Coverage
- Eligibility
- Program Administration
- Renewals
- COVID-19
- Unwinding
Type: Informational Bulletin
Financial Eligibility Verification Requirements and Flexibilities
Date:
Topics:
- Access to Care
- Eligibility
- Program Administration
- Renewals
- Coverage
- Children's Health Insurance Program
- COVID-19
- Unwinding
Type: Informational Bulletin
State Medicaid Director Letter: Permanent Extension of Mandatory Medicaid State Plan Coverage of MAT/MOUD
Date:
Topics:
- Benefits
- Coverage
- Mental Health
- Program Administration
- Substance Use Disorders
Type: State Medicaid Director Letter
Use of Unwinding-Related Strategies to Support Long-Term Improvements to State Medicaid Eligibility and Enrollment Processes
Date:
Topics:
- Eligibility
- Program Administration
- Renewals
- Access to Care
- Coverage
- Children's Health Insurance Program
- COVID-19
- Unwinding
Type: Informational Bulletin
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