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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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:
Notice of Technology and Process Upgrades for Account Transfer Functionality for States Served by Marketplaces on the Federal Platform
Date:
Topics:
- Data & Systems
- Eligibility
- Outreach & Enrollment
- Marketplace
Type: Informational Bulletin
Final Rule: Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program
Date:
Topics:
- Benefits
- Prescription Drugs
Type: Regulations
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
Type: State Health Official Letter
State Compliance with Medicaid and CHIP Renewal Requirements by December 31, 2026
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Compliance
- Outreach & Enrollment
- Program Administration
- Renewals
Type: Informational Bulletin
Guidelines for Achieving Compliance with Medicaid and CHIP Eligibility Renewal Timeliness Requirements Following the Medicaid and CHIP Unwinding Period
Date:
Topics:
- Access to Care
- Children's Health Insurance Program
- Eligibility
- Outreach & Enrollment
- Program Administration
- Renewals
Type: Informational Bulletin
Budget Neutrality for Section 1115(a) Medicaid Demonstration Projects SMDL (SMD 24-003)
Date:
Topics:
- Program Administration
- Section 1115 Demonstrations
Type: State Medicaid Director Letter
Basic Health Program; Federal Funding Methodology for Program Year 2025
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
Type: Informational Bulletin
Ensuring Continuity of Coverage for Individuals Receiving Home and Community-Based Services
Date:
Topics:
- Access to Care
- Program Administration
Type: Informational Bulletin
Medicaid Family Planning Services and Supplies: Requirements and Best Practices
Date:
Topics:
- Program Administration
- Access to Care
- Cost Sharing
- Prescription Drugs
Type: Informational Bulletin