Federal Policy Guidance

As part of the state-federal partnership in administering the Medicaid and CHIP programs, the Centers for Medicare and Medicaid Services (CMS) issues guidance in the form of letters to State Medicaid Directors, letters to State Health Officials (often regarding CHIP policy or financing issues), Informational Bulletins, and Frequently Asked Questions to communicate with states and other stakeholders regarding operational issues related to Medicaid and CHIP. In addition, CMS issues federal regulations that codify statutory provisions and also policies that have been previously outlined in sub-regulatory guidance. The supporting documents are searchable on this page.

Regulations

CMS periodically issues regulations to codify policies based on statutory provisions of the Social Security Act. Regulations come in several forms, including the following:

Notice of Proposed Rulemaking (NPRM) that proposes policy approaches to implementing provisions of the statute and solicits public comment on the proposals.
Interim Final Rule with Comment goes into effect when it is published, but will be open for public comment for a specific period of time and then potentially revised and issued as a Final Rule.
Final Rules take comments into consideration and formally codify policies that were proposed in the NPRM or IFC.

For regulatory policy guidance not found on this page, please visit Regulations.gov

State Medicaid Director and State Health Official Letters

State Medicaid Director Letters and State Health Official Letters are used to provide states with guidance and clarification on current information and/or statutory changes pertaining to Medicaid and CHIP policy and financing.

Center for Medicaid & CHIP Services (CMCS) Informational Bulletins

Created in late 2009, CMCS Informational Bulletins are used to communicate with states and other stakeholders interested in Medicaid and CHIP. These communications do not establish new policy; they are designed to highlight recently released policy guidance and regulations and also to share important operational and technical information related to Medicaid and CHIP.

Frequently Asked Questions (FAQ)

Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below. For more information about the increased FMAP rates available beginning in 2014 and beyond, click here.

To search for individual Qs&As click here.