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:
State Guidance on Claiming Methodologies for Medicaid Managed Care (SMD 23-005)
Date:
Topics:
- Financing & Reimbursement
- Managed Care
Type: State Medicaid Director Letter
Mandatory Medicaid and Children’s Health Insurance Program Coverage of Adult Vaccinations under the Inflation Reduction Act
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Cost Sharing
- Financing & Reimbursement
- Managed Care
- Reimbursement
- COVID-19
Type: State Health Official Letter
Information on School-Based Services in Medicaid: Policy Flexibilities and Guide on Coverage, Billing, Reimbursement, Documentation and School-Based Administrative Claiming
Date:
Topics:
- Benefits
- Children's Health Insurance Program
Type: Informational Bulletin
2023 Federal Poverty Level Standards
Date:
Topics:
- Children's Health Insurance Program
- Eligibility
- Medicaid-Medicare Issues
- Program Administration
Type: Informational Bulletin
Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program (CHIP)
Date:
Topics:
- Benefits
- Financing & Reimbursement
- Children's Health Insurance Program
- COVID-19
Type: State Health Official 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:
Updates to the Child and Adult Core Health Care Quality Measurement Set
Date:
Topics:
- Children's Health Insurance Program
- CHIPRA
- Program Administration
- Quality of Care
Type: Informational Bulletin
Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes (CMS-2421-P)
Date:
Topics:
- Children's Health Insurance Program
- Eligibility
- Medicaid-Medicare Issues
- Program Administration
- Basic Health Program
Type: Regulations
Leveraging Medicaid, CHIP and Other Federal Programs in the Delivery of Behavioral Health Services for Children and Youth
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
- COVID-19
Type: Informational Bulletin
Medicaid and CHIP Managed Care Monitoring and Oversight Tools #2
Date:
Topics:
- Children's Health Insurance Program
- Managed Care
- Program Integrity
- Quality of Care
- Delivery System
Type: Informational Bulletin