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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Changes to Modified Adjusted Gross Income (MAGI)-based Income Methodologies
Date:
Topics:
- Eligibility
Type: State Health Official Letter
Key Provisions of Legislation Extending Federal Funding for CHIP
Date:
Topics:
- Children's Health Insurance Program
- Financing & Reimbursement
Type: State Health Official Letter
Transformed-Medicaid Statistical Information System (T-MSIS)
Date:
Topics:
- Data & Systems
- Managed Care
- Program Administration
- Program Integrity
Type: State Health Official Letter
Medicaid Family Planning Services and Supplies
Date:
Topics:
- Affordable Care Act (ACA)
- Benefits
- Eligibility
Type: State Health Official Letter
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
Federal Funding for Services "Received Through" an IHS/Tribal Facility and Furnished to Medicaid-Eligible American Indians and Alaska Natives
Date:
Topics:
- Benefits
- Financing & Reimbursement
- Tribal Issues
Type: State Health Official Letter
Obergefell v. Hodges and Eligibility for Medicaid/CHIP
Date:
Topics:
- Eligibility
- Program Administration
Type: State Health Official Letter
Payment Error Rate Measurement (PERM) eligibility reviews, Medicaid Eligibility Quality Control (MEQC) Program, and extension of an interim approach for assessing payment error for eligibility
Date:
Topics:
- Affordable Care Act (ACA)
- Program Integrity
- Eligibility
Type: State Health Official Letter
Policy Options for Using SNAP to Determine Medicaid Eligibility and an Update on Targeted Enrollment Strategies
Date:
Topics:
- Eligibility
Type: State Health Official Letter