Medicaid State Technical Assistance

The staff in the Center for Medicaid and CHIP Services (CMCS) provides technical assistance to states on an ongoing basis on all Medicaid and the Childrens's Health Insurance Program (CHIP) topics. However, for several specific programs, CMCS has also contracted with outside entities to provide technical assistance to states on behalf of CMCS. Below are brief descriptions of each technical assistance provider and links to additional information.

SOTA 2.0

In spring 2012, the State Operations and Technical Assistance (SOTA) initiative was created to work through policy and operational changes required in Medicaid by the Affordable Care Act. In July 2015, the Centers for Medicare & Medicaid Services (CMS) announced an enhancement to this initiative called SOTA 2.0.

The goal of SOTA 2.0 is to provide a smoother and more efficient experience for states when working across CMS on Medicaid-related issues. By creating a team that will organize itself around a state and can be accountable to them, we believe that the new SOTA 2.0 structure will provide states a more seamless experience as they work with CMS. Contact your SOTA leads or submit your inquiry to sotaupdates@cms.hhs.gov.

Managed Care

Direct technical assistance is available from CMS to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating managed care programs. States are encouraged to submit these requests for any managed care question, but some examples of requests include: managed care authorities, rate setting, contract language, benefit design, access to care or data. 

Home & Community-Based Services

Home and community-based services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community. These programs serve a variety of targeted populations groups, such as people with mental illnesses, intellectual disabilities, and/or physical disabilities. States have several options including state plan amendments (SPAs) and waivers, to provide home and community-based services.

CMS has partnered with an HCBS technical assistance contractor to offer free technical assistance and training to state agencies that would like to develop or improve HCBS under the section 1915 (c) waivers or sections 1915 (i), 1915 (j) or 1915 (k) SPAs. The HCBS technical assistance contractor can also provide guidance on how these authorities might interact with one another and with Section 1115 demonstration waivers. Technical assistance and training spans a variety of systems-change related topics including but not limited to:

  • Strategic planning
  • Determining which HCBS authority is most appropriate for your state
  • Community integration supports for people with disabilities
  • Supported employment supports
  • Person-centered planning as it relates to systems of services and support
  • Individual budgeting and fiscal management services, related to self-direction
  • Service design and needs-based criteria
  • Population targeting
  • Program implementation
  • Assist in Medicaid program and payment mechanisms to implement the Fair Labor Standards Act
  • Conflict of interest
  • Mortality and morbidity data collection and analysis

Technical assistance can be provided virtually or in-person to support the needs of the state.

Health Homes

The Affordable Care Act of 2010, section 2703, created an optional Medicaid state plan benefit for states to establish Health Homes to coordinate care for people with Medicaid who have chronic conditions by adding section 2703 of the Social Security Act. CMS expects states health home providers to operate under a "whole-person" philosophy. Health Homes providers will integrate and coordinate all primary, acute, behavioral health, and long-term services and supports to treat the whole person.

For more information, visit:

Preadmission Screen & Resident Review (PASRR)

Preadmission Screening and Resident Review (PASRR) is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long-term care. PASRR requires that 1) all applicants to a Medicaid-certified nursing facility be evaluated for mental illness and/or intellectual disability; 2) be offered the most appropriate setting for their needs (in the community, a nursing facility, or acute care settings); and 3) receive the services they need in those settings. The PASRR Technical Assistance Center provides information in a variety of formats available from the link below, and offers free individual consultation to any state agency involved with PASRR, from simple questions to intensive on-site review and program design.

Money Follows the Person

The Money Follows the Person (MFP) rebalancing demonstration program, authorized under Section 6071 of the Deficit Reduction Act and amended under Section 2403 of the Affordable Care Act, is designed to support states in rebalancing their long-term service delivery systems. States participating in the MFP demonstration must establish a program that identifies Medicaid beneficiaries in institutional care who desire to live in the community and helps them to do so. States are also required to implement a rebalancing program that allows more Medicaid long-term care expenditures to flow to community services and supports. 

The MFP Technical Assistance Center provides guidance and consultation to CMS, MFP grantees, their partners, and other relevant state and local agencies/organizations to support the implementation of state specific MFP demonstration programs. A technical assistance team comprised of expert consultants has been developed which emphasizes a customized approach toward assisting grantees with successfully implementing their MFP demonstration program.

For more information, visit:

This technical assistance contractor also provides specific information and assistance around Housing Supports for Community Living and Direct Service Workforce topics.

For more information, visit:

Testing Experience & Functional Tools

In March 2014, CMS awarded Testing Experience and Functional Tools (TEFT) grants to nine states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (CB-LTSS). The grant program, spanning four years through March 2018, is designed to field test an experience of care survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS plan.

For more information, visit: