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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Opportunities to Improve HIV Testing, Prevention, and Care Delivery for Medicaid and CHIP Beneficiaries
Date:
Topics:
- Access to Care
- Coverage
- Prescription Drugs
Type: Informational Bulletin
Medicaid Family Planning Services and Supplies: Requirements and Best Practices
Date:
Topics:
- Program Administration
- Access to Care
- Cost Sharing
- Prescription Drugs
Type: Informational Bulletin
Beneficiary Protections and Medicaid Drug Coverage - Under Value Based Purchasing (VBP) and Other Innovative Payment Arrangements
Date:
Topics:
- Prescription Drugs
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
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
CIB: Medicaid Managed Care Frequently Asked Questions (FAQs) – Medical Loss Ratio
Date:
Topics:
- Managed Care
- Program Administration
- Children's Health Insurance Program
- Delivery System
- Financing & Reimbursement
Type: Informational Bulletin
CIB: Medicaid Managed Care Options in Responding to COVID-19
Date:
Topics:
- Managed Care
- Financing & Reimbursement
- Delivery System
- COVID-19
Type: Informational Bulletin
Best Practices for Avoiding 340B Duplicate Discounts in Medicaid
Date:
Topics:
- Prescription Drugs
Type: Informational Bulletin
Medicaid Prescription Spread Pricing
Date:
Topics:
- Financing & Reimbursement
- Affordable Care Act (ACA)
- Prescription Drugs
Type: Informational Bulletin