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
Medicaid Enterprise Systems Compliance and Reapproval Process for State Systems with Operational Costs Claimed at the 75 Percent Federal Match Rate
Date:
Topics:
- Data & Systems
- COVID-19
- Unwinding
Type: Informational Bulletin
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:
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
Updated Reporting Requirements and Extension of Deadline to Fully Expend State Funds Under American Rescue Plan Act of 2021 Section 9817 (SMD 22-002)
Date:
Topics:
- Benefits
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
Type: State Medicaid Director Letter
Updated Medicaid Information Technology Systems Guidance: Streamlined Modular
Certification for Medicaid Enterprise Systems
Certification for Medicaid Enterprise Systems
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
Third Party Liability in Medicaid: State Compliance with Changes Required in Bipartisan Budget Act of 2018 and Medicaid Services Investment and Accountability Act of 2019
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Cost Sharing
- Data & Systems
- Delivery System
- Eligibility
- Financing & Reimbursement
- Long-Term Services & Support
- Managed Care
- Outreach & Enrollment
- Program Administration
- Program Integrity
Type: Informational Bulletin
Medicaid and CHIP Managed Care Monitoring and Oversight Tools
Date:
Topics:
- Children's Health Insurance Program
- Managed Care
- Program Integrity
- Quality of Care
- Delivery System
Type: Informational Bulletin