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:
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
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
Type: State Medicaid Director Letter
Third-Party Liability in Medicaid: State Compliance with Changes Required in Law and Court Rulings (SMD 23-002)
Date:
Topics:
- Eligibility
- Program Administration
Type: State Medicaid Director 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:
Additional Guidance on Section 9815 of the American Rescue Plan Act of 2021 (SMD 22-006)
Date:
Topics:
- Program Administration
- Financing & Reimbursement
Type: State Medicaid Director Letter
Guidance on Nursing Facility State Plan Payment and Upper Payment Limit Approaches in Medicaid Relying on the Medicare Patient-Driven Payment Model (SMD 22-005)
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter