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.
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Policy Program
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Regulations
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Regulations implement laws passed by Congress and are published in the Federal Register. There are a variety of regulatory actions, some involving public comment. Although the types of actions can vary, generally CMS publishes a notice of proposed rule-making, solicits and considers public comments, and issues a final rule.
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State Medicaid Director Letters
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State Medicaid Director (SMD) letters further clarify and communicate policies set forth in regulations. They provide Medicaid-related guidance and clarify statutory and regulatory issues.
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State Health Official Letters
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State Health Official (SHO) letters are similar to SMD letters, but they generally apply to both Medicaid and CHIP programs. Like SMD letters they provide guidance and clarify statutory and regulatory issues.
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Frequently Asked Questions
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Frequently Asked Questions (FAQ) can clarify and provide guidance on regulatory or sub-regulatory issues. They can also be used to address operational and technical issues. In addition to the point-in-time releases, CMS also offers an interactive FAQ library.
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Center for Medicaid & CHIP Services (CMCS) Informational Bulletins
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CMCS Informational Bulletins (CIBs) share information, address operational and technical issues, and highlight initiatives or related efforts. CIBs do not establish new policy or issue new guidance.