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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Upper Payment Limit Requirements
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Coverage, Coding and Reasonable Payment for HIV-1 and Resistance Testing
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Policy for the Review of State Plan Amendments
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Creating equitable risk adjustment payment systems for Managed Care Organizations
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
National Coverage Decision for Costs Related to Participation in Clinical Trials
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Cost-Based Reimbursement, Financial Incentives and Managed Care Organization Insolvency-FQHCs/RHCs
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Links:
HIPAA Medicaid Management Information Systems (MMIS) Funding
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
Medicare Enrollment Database (EDB) Extract Request
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
Systems Performance Review (SPR) Requirement Elimination-Modification of Medicaid Management Information System (MMIS)
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
Upper Payment Limits to Government-Owned Facilities
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter