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:
Healthy Adult Opportunity State Guidance (SMD 25-001)
Date:
Topics:
- Delivery System
- Program Administration
- Section 1115 Demonstrations
Type: State Medicaid Director Letter
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:
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
Budget Neutrality for Section 1115(a) Medicaid Demonstration Projects SMDL (SMD 24-003)
Date:
Topics:
- Program Administration
- Section 1115 Demonstrations
- COVID-19
Type: State Medicaid Director Letter
Initial Core Set Mandatory Reporting Guidance for the Health Home Core Quality Measure Sets and Federal Fiscal Year 2025 Updates to the Health Home Core Quality Measure Sets (SMD 24-002)
Date:
Topics:
- Long-Term Services & Support
- Quality of Care
Type: State Medicaid Director Letter
Administrative Claiming for Nurse Advice Lines and for Skilled Professional Medical Personnel for Certain Behavioral Health Professionals (SMD 24-001)
Date:
Topics:
- Program Administration
Type: State Medicaid Director Letter
Assurance of Transportation: A Medicaid Transportation Coverage Guide (SMD 23-006)
Date:
Topics:
- Benefits
- Reimbursement
Type: State Medicaid Director Letter
State Guidance on Claiming Methodologies for Medicaid Managed Care (SMD 23-005)
Date:
Topics:
- Financing & Reimbursement
- Managed Care
Type: State Medicaid Director Letter
Extension of 1915(c) Home and Community-Based Services Waiver Appendix K Expiration Dates (SMD 23-004)
Date:
Topics:
- Long-Term Services & Support
- Program Administration
- COVID-19
- Unwinding
Type: State Medicaid Director Letter
Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated (SMD 23-003)
Date:
Topics:
- Benefits
- Program Administration
- Eligibility
- COVID-19
Type: State Medicaid Director Letter