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:
Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements (CMS 2482-P)
Date:
Topics:
- Prescription Drugs
- Eligibility
Type: Regulations
Basic Health Program Funding Methodology Proposed Payment Notice for Program Year 2021
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
- Basic Health Program
Type: Regulations
Best Practices for Avoiding 340B Duplicate Discounts in Medicaid
Date:
Topics:
- Prescription Drugs
Type: Informational Bulletin
New Reporting Measures for Substance Use Disorder (SUD)-focused Health Homes
Date:
Topics:
- Affordable Care Act (ACA)
- Program Administration
Type: Informational Bulletin
Covered Outpatient Drug; Further Delay Of Inclusion Of Territories In Definitions Of State And United States (CMS–2345–IFC3) – Interim Final with Comment
Date:
Topics:
- Financing & Reimbursement
- Prescription Drugs
Type: Regulations
Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED) Demonstration Opportunity Technical Assistance Questions and Answers
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Managed Care
Type: Frequently Asked Questions
Basic Health Program Funding Methodology Final Notice for Program Years 2019 and 2020
Date:
Topics:
- Affordable Care Act (ACA)
- Cost Sharing
- Benefits
- Financing & Reimbursement
- Program Administration
- Eligibility
- Basic Health Program
Type: Regulations
Disproportionate Share Hospital Reductions CMS-2394-F
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
Type: Regulations
New State Flexibilities and Requirements regarding Alternative Benefit Plans (ABP) and Essential Health Benefits (EHB)
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Eligibility
- Program Administration
Type: Informational Bulletin
Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
Date:
Topics:
- Affordable Care Act (ACA)
- Long-Term Services & Support
Type: Informational Bulletin