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:
Healthy Adult Opportunity State Guidance (SMD 25-001)
Date:
Topics:
- Delivery System
- Program Administration
- Section 1115 Demonstrations
Type: State Medicaid Director Letter
Protecting Medicaid Beneficiaries Against Impermissible Fraud and Abuse Sanctions (SMD 24-005) [RESCINDED ON MAY 1, 2025]
Date:
Topics:
- Access to Care
- Compliance
- Program Administration
- Program Integrity
Type: State Medicaid Director Letter
Additional Guidance on State Directed Payments in Medicaid Managed Care
Date:
Topics:
- Managed Care
- Program Administration
- Delivery System
- Financing & Reimbursement
Type: State Medicaid Director Letter
Value-Based Care Opportunities in Medicaid
Date:
Topics:
- Delivery System
- Value-based Care
- Financing & Reimbursement
- COVID-19
Type: State Medicaid Director Letter
Mechanized Claims Processing and Information Retrieval Systems-Enhanced Funding
Date:
Topics:
- Cost Sharing
- Data & Systems
- Delivery System
- Financing & Reimbursement
Type: State Medicaid Director Letter
SMD: New Service Delivery Opportunities for Individuals with a Substance Use Disorder
Date:
Topics:
- Benefits
- Delivery System
Type: State Medicaid Director Letter
Accountability #2: Financing and Donations
Date:
Topics:
- Financing & Reimbursement
- Program Administration
- Program Integrity
Type: State Medicaid Director Letter
Transformed Medicaid Statistical Information System (T-MSIS) Data
Date:
Topics:
- Data & Systems
- Managed Care
- Program Administration
- Program Integrity
Type: State Medicaid Director Letter
Reduce Improper Payments to providers
Date:
Topics:
- Program Integrity
Type: State Medicaid Director Letter
Strengthen Program Integrity and Reduce Improper Payments to Providers
Date:
Topics:
- Program Integrity
Type: State Medicaid Director Letter