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:
Coverage of Services and Supports to Address Health-Related Social Needs in Medicaid and CHIP
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Financing & Reimbursement
- Health Related Social Needs
- Section 1115 Demonstrations
Type: Informational Bulletin
Links:
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
Type: Informational Bulletin
Financial Eligibility Verification Requirements and Flexibilities
Date:
Topics:
- Access to Care
- Eligibility
- Program Administration
- Renewals
- Coverage
- Children's Health Insurance Program
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
2025 SSI, Spousal Impoverishment, and Medicare Savings Program Resource Standards
Date:
Topics:
- Eligibility
Type: Informational Bulletin
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
Type: Informational Bulletin
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