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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Supplemental Drug Rebate Agreements and Prior Authorization of Covered Outpatient Drugs
Date:
Topics:
- Prescription Drugs
Type: State Medicaid Director Letter
Medicaid Disproportionate Share Hospital (DSH) Program - Supplemental Upper Payment Limit Payments and Payment for Prison Inmate Care
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Promising State Practices to Reduce Unnecessary Nursing Facility Placement
Date:
Topics:
- Long-Term Services & Support
Type: State Medicaid Director Letter
Medicaid National Institutional Reimbursement Team (NIRT)
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Procedures for Requesting Retrospective Medicare Claims from Medicare's National Claims History Standard Analytical Files
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter
Template Applications for Independence Plus: a Program for Family or Individual Directed Community Services
Date:
Topics:
- Long-Term Services & Support
Type: State Medicaid Director Letter
Transition Costs Covered under Home and Community Based Services Waiverss
Date:
Topics:
- Long-Term Services & Support
Type: State Medicaid Director Letter
Medicaid Payment Accuracy Measurement (PAM) Project
Date:
Topics:
- Financing & Reimbursement
Type: State Medicaid Director Letter
Public Input to Comprehensive 1115 Waivers, HCBS Waivers and Managed Care Waiverss
Date:
Topics:
- Long-Term Services & Support
Type: State Medicaid Director Letter
Implementation of HIPAA's Administrative Simplification Provisions
Date:
Topics:
- Data & Systems
Type: State Medicaid Director Letter