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
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Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
Date:
Topics:
- Affordable Care Act (ACA)
- Long-Term Services & Support
Type: Informational Bulletin
Help for Moms and Babies - Medicaid Coverage for services to Pregnant/Post-partum Women Outside of an IMD (Section 1012)
Date:
Topics:
- Benefits
Type: Informational Bulletin
SPA Residential Pediatric Recovery Center – Guidance to States (Section 1007)
Date:
Topics:
- Benefits
Type: Informational Bulletin
Joint CMCS and SAMHSA Informational Bulletin: Information to States and School Systems on Addressing Mental Health and Substance Use Issues in Schools
Date:
Topics:
- Benefits
- Eligibility
- Program Administration
Type: Informational Bulletin
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
Medicaid Prescription Spread Pricing
Date:
Topics:
- Financing & Reimbursement
- Affordable Care Act (ACA)
- Prescription Drugs
Type: Informational Bulletin
Guidance for States on the Availability of an Extension of the Enhanced Federal Medical Assistance Percentage (FMAP) Period for Certain Medicaid Health Homes for Individuals with Substance Use Disorders (SUD)
Date:
Topics:
- Affordable Care Act (ACA)
- Program Administration
Type: Informational Bulletin
Reassignment of Medicaid Provider Claims Final Rule
Date:
Topics:
- Affordable Care Act (ACA)
Type: Regulations
Basic Health Program; Federal Funding Methodology for Program Years 2019 and 2020 (CMS-2407-PN)
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Cost Sharing
- Eligibility
- Financing & Reimbursement
- Program Administration
- Basic Health Program
Type: Regulations
Links:
Final Rule and Interim Final Rule with Comment Period: Medicaid Program; Covered Outpatient Drug; Finalization of Line Extension Definition; and Change to the Rebate Calculation for Line Extension Drugs (CMS-2345-F2 and 2345-IFC2)
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: