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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The Use of New or Increased Pass-Through Payments in Medicaid Managed Care Delivery Systems
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Delivery System
- Managed Care
- Quality of Care
Type: Informational Bulletin
Coordination of Eligibility and Enrollment between Medicaid, CHIP and the Federally Facilitated Marketplace (FFM or "Marketplace")
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Data & Systems
- Eligibility
- Outreach & Enrollment
Type: Informational Bulletin
Covered Outpatient Drug Final Rule with Comment (CMS-2345-FC)
Date:
Topics:
- Affordable Care Act (ACA)
- Financing & Reimbursement
- Prescription Drugs
Type: Frequently Asked Questions
Addendum to 2016 Medicaid Managed Care Rate Development Guide
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Delivery System
- Managed Care
- Quality of Care
Type: Informational Bulletin
Mechanized Claims Processing and Information Retrieval Systems -APD Requirements
Date:
Topics:
- Affordable Care Act (ACA)
- Data & Systems
- Financing & Reimbursement
Type: State Medicaid Director Letter
Federal public notice and public process requirements for changes to Medicaid payment rates
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Data & Systems
- Financing & Reimbursement
Type: Informational Bulletin
Medicaid Family Planning Services and Supplies
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Eligibility
Type: State Health Official Letter
Strategies to Enroll and Retain Eligible Children in Medicaid and CHIP
Date:
Topics:
- Affordable Care Act (ACA)
- Children's Health Insurance Program
- CHIPRA
- Outreach & Enrollment
Type: Informational Bulletin
To Facilitate successful re-entry for individuals transitioning from incarceration to their communities (SHO 16-007)
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Eligibility
Type: State Health Official Letter
Federally-Qualified Health Center (FQHC) and Rural Health Clinic (RHC) Supplemental Payment Requirements and FQHC, RHC, and Freestanding Birth Center (FBC) Network Sufficiency under Medicaid and CHIP Managed Care
Date:
Topics:
- Affordable Care Act (ACA)
- Children's Health Insurance Program
- Financing & Reimbursement
- Managed Care
Type: State Health Official Letter