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
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
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
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
Strong Start for Mothers and Newborns initiative (Strong Start)
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Children's Health Insurance Program
- Delivery System
- Financing & Reimbursement
- Quality of Care
Type: Informational Bulletin
Requirements of Section 12005 of the 21st Century Cures Act - EPSDT
Date:
Topics:
- Benefits
- Children's Health Insurance Program
- Delivery System
- Eligibility
- Managed Care
- Quality of Care
Type: Informational Bulletin