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Request for Information (RFI): Access to Coverage and Care in Medicaid & CHIP
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* Federal Policy Guidance
* Resources for States
* 1. Innovation Accelerator Program
1. Program Areas
2. Functional Areas
2. Medicaid State Technical Assistance
1. Health Home Information Resource Center
3. Medicaid and CHIP Program Portal
1. Eligibility & Administration SPA Implementation Guides
2. MACPro Training & Help
4. MAC Learning Collaboratives
1. Data Analytics
2. Expanding Coverage
3. Exchange Innovators
4. Federally Facilitated Marketplace
5. Value-Based Purchasing
5. Disaster Response Toolkit
1. State Plan Flexibilities
2. Using Section 1115 Demonstrations for Disaster Response
3. Home & Community-Based Services in Public Health Emergencies
4. Federal Disaster Resources
5. Section 1135 Waiver Flexibilities
6. Coronavirus Disease 2019 (COVID-19)
1. Unwinding and Returning to Regular Operations after COVID-19
2. Medicaid and CHIP Resources
3. CMCS Medicaid and CHIP All State Calls
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6. Other Agency Guidance
7. Press Releases
7. SPA and 1915 Waiver Processing
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3. Medicaid SPA Toolkit
8. Medicaid and CHIP Eligibility & Enrollment Webinars
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* 1. Medicaid State Plan Amendments
2. Access to Care
1. Access Monitoring Review Plans
3. Program Integrity
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2. Affordable Care Act Program Integrity Provisions
4. Cost Sharing
1. Cost Sharing Exemptions
2. Out of Pocket Costs
5. Indian Health & Medicaid
1. History
2. Indian Health Care Improvement Act
3. American Recovery & Reinvestment Act
4. Tribal Affairs Guidance & Resources
6. Outreach Tools
1. Supporting Enrollment Efforts
2. Helping Connect Enrollees to Care
3. Living Well
7. Quality of Care
1. Medicaid Managed Care
2. Improvement Initiatives
3. Performance Measurement
4. Releases & Announcements
8. Enrollment Strategies
1. Continuous Eligibility
2. Express Lane Eligibility
3. Lawfully Residing Immigrant Children & Pregnant Women
4. Presumptive Eligibility
9. Home & Community Based Services
1. Home & Community Based Services Authorities
2. HCBS Training
3. Guidance
4. Statewide Transition Plans
5. Technical Assistance
10. Program Information
1. Medicaid & CHIP Eligibility Levels
2. Medicaid & CHIP Enrollment Data
3. Medicaid & CHIP Marketplace Interactions
4. Targeted Enrollment Strategies
5. Eligibility Verification Policies
11. Section 1115 Demonstrations
1. About 1115 Demonstrations
2. How States Apply
3. Transparency
4. 1115 Demonstration Monitoring & Evaluation
5. State Waivers List
6. 1115 Substance Use Disorder Demonstrations
7. Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations
12. Managed Care
1. Managed Care Authorities
2. Enrollment Report
3. Managed Care Entities
4. Guidance
5. Managed LTSS
6. Profiles & Program Features
7. Technical Assistance
13. Eligibility
1. Estate Recovery
2. MAGI Conversion Plan
3. Seniors & Medicare and Medicaid Enrollees
4. Verification Plans
5. Minimum Essential Coverage
6. Spousal Impoverishment
7. Medicaid Third Party Liability & Coordination of Benefits
8. Medicaid Eligibility Quality Control Program
14. Financial Management
1. Payment Limit Demonstrations
2. Disproportionate Share Hospitals
3. Medicaid Administrative Claiming
4. State Budget & Expenditure Reporting for Medicaid and CHIP
5. Provider Preventable Conditions
6. Actuarial Report on the Financial Outlook for Medicaid
7. Section 223 Demonstration Program to Improve Community Mental
Health Services
15. Data & Systems
1. Medicaid Enterprise Systems Newsletter
2. MACBIS
3. Medicaid Information Technology Architecture
4. Medicaid Management Information System
5. Medicaid Enterprise Certification Toolkit
6. Medicaid Eligibility & Enrollment Toolkit
7. Medicaid Enterprise Reuse
8. Health Information Technology
9. Health Information Exchange
10. IT Procurement Opportunities
11. Outcomes-Based Certification
16. Benefits
1. Alternative Benefit Plans
2. Autism Services
3. Behavioral Health Services
4. Dental Care
5. Early and Periodic Screening, Diagnostic, and Treatment
6. Hospice Benefits
7. Mandatory & Optional Medicaid Benefits
8. Prevention
9. Telemedicine
17. Prescription Drugs
1. Branded Prescription Drug Fee Program
2. Drug Utilization Review
3. Federal Upper Limit
4. Medicaid Drug Policy
5. Medicaid Drug Rebate Program
6. Pharmacy Pricing
7. Program Releases
8. Retail Price Survey
9. State Drug Utilization Data
10. State Prescription Drug Resources
18. Long Term Services & Supports
1. Health Homes
2. Person-Centered Hospital Discharge Model
3. Person-Centered Planning Grants
4. State Profile Tool Grant
5. Balancing Long Term Services & Supports
6. Integrating Care
7. Employment Initiatives
8. Institutional Long Term Care
9. Money Follows the Person
10. PACE
11. Alternatives to Psychiatric Residential Treatment Facilities
Demonstration
12. Reports & Evaluations
13. Self-Directed Services
14. Testing Experience & Functional Tools demonstration
15. Workforce Initiative
* CHIP
* 1. Benefits
2. Eligibility Standards
1. Waiting Periods
3. Cost Sharing
4. Financing
5. CHIPRA
1. CHIPRA Awards & Performance Bonus
6. CHIP State Program Information
7. Reports & Evaluations
8. CHIP Managed Care
9. CHIP Quality & Performance
* Basic Health Program
* State Overviews
* 1. Scorecard
1. National Context
2. State Health System Performance
3. State Administrative Accountability
4. Federal Administrative Accountability
2. State Profiles
3. Medicaid MAGI & CHIP Application Processing Time
* About Us
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2. Beneficiary Resources
3. Visit CMS
4. Contact Us
5. Program History
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* Federal Policy Guidance
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High Costs
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* Functional Areas
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* Health Home Information Resource Center
* Medicaid and CHIP Program Portal
* Medicaid and CHIP Program Portal
* Eligibility & Administration SPA Implementation Guides
* MACPro Training & Help
* MAC Learning Collaboratives
* MAC Learning Collaboratives
* Data Analytics
* Expanding Coverage
* Exchange Innovators
* Federally Facilitated Marketplace
* Value-Based Purchasing
* Disaster Response Toolkit
* Disaster Response Toolkit
* State Plan Flexibilities
* Using Section 1115 Demonstrations for Disaster Response
* Home & Community-Based Services in Public Health Emergencies
* Federal Disaster Resources
* Section 1135 Waiver Flexibilities
* Coronavirus Disease 2019 (COVID-19)
* Coronavirus Disease 2019 (COVID-19)
* Unwinding and Returning to Regular Operations after COVID-19
* Medicaid and CHIP Resources
* Guidance and FAQs
* Data Releases
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* Press Releases
* SPA and 1915 Waiver Processing
* SPA and 1915 Waiver Processing
* 1915 Waiver Toolkit
* CHIP SPA Toolkit
* Medicaid SPA Toolkit
* Medicaid and CHIP Eligibility & Enrollment Webinars
* Medicaid
* Medicaid
* Medicaid State Plan Amendments
* Access to Care
* Access to Care
* Access Monitoring Review Plans
* Program Integrity
* Program Integrity
* National Correct Coding Initiative
* Edit Files
* Methodologies
* Reference Documents
* Affordable Care Act Program Integrity Provisions
* Cost Sharing
* Cost Sharing
* Cost Sharing Exemptions
* Out of Pocket Costs
* Indian Health & Medicaid
* Indian Health & Medicaid
* History
* Indian Health Care Improvement Act
* American Recovery & Reinvestment Act
* Tribal Affairs Guidance & Resources
* Outreach Tools
* Outreach Tools
* Supporting Enrollment Efforts
* Helping Connect Enrollees to Care
* Living Well
* Quality of Care
* Quality of Care
* Medicaid Managed Care
* Improvement Initiatives
* Performance Measurement
* Releases & Announcements
* Enrollment Strategies
* Enrollment Strategies
* Continuous Eligibility
* Express Lane Eligibility
* Lawfully Residing Immigrant Children & Pregnant Women
* Presumptive Eligibility
* Home & Community Based Services
* Home & Community Based Services
* Home & Community Based Services Authorities
* HCBS Training
* Guidance
* Statewide Transition Plans
* Technical Assistance
* Program Information
* Program Information
* Medicaid & CHIP Eligibility Levels
* Medicaid & CHIP Enrollment Data
* September 2021 Medicaid & CHIP Enrollment Data Highlights
* Monthly Reports
* Medicaid and CHIP Enrollment Snapshot
* Report Methodology
* Medicaid Enrollment Data Collected Through MBES
* Performance Indicator Technical Assistance
* Medicaid & CHIP Marketplace Interactions
* Targeted Enrollment Strategies
* Eligibility Verification Policies
* Section 1115 Demonstrations
* Section 1115 Demonstrations
* About 1115 Demonstrations
* How States Apply
* Transparency
* 1115 Demonstration Monitoring & Evaluation
* State Waivers List
* 1115 Substance Use Disorder Demonstrations
* Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations
* Managed Care
* Managed Care
* Managed Care Authorities
* Enrollment Report
* Managed Care Entities
* Guidance
* Managed LTSS
* Profiles & Program Features
* Technical Assistance
* Eligibility
* Eligibility
* Estate Recovery
* MAGI Conversion Plan
* Seniors & Medicare and Medicaid Enrollees
* Verification Plans
* Minimum Essential Coverage
* Spousal Impoverishment
* Medicaid Third Party Liability & Coordination of Benefits
* Medicaid Eligibility Quality Control Program
* Financial Management
* Financial Management
* Payment Limit Demonstrations
* Upper Payment Limit FAQs
* Disproportionate Share Hospitals
* Medicaid Administrative Claiming
* LTC Ombudsman Programs
* No Wrong Door
* Translation and Interpretation
* State Budget & Expenditure Reporting for Medicaid and CHIP
* Expenditure Reports MBES/CBES
* CMS-64 FFCRA Increased FMAP Expenditure Data
* Provider Preventable Conditions
* Actuarial Report on the Financial Outlook for Medicaid
* Section 223 Demonstration Program to Improve Community Mental Health
Services
* Data & Systems
* Data & Systems
* Medicaid Enterprise Systems Newsletter
* MACBIS
* Medicaid Information Technology Architecture
* Medicaid Management Information System
* Medicaid Enterprise Certification Toolkit
* Medicaid Eligibility & Enrollment Toolkit
* Medicaid Enterprise Reuse
* Health Information Technology
* Health Information Exchange
* IT Procurement Opportunities
* Outcomes-Based Certification
* Benefits
* Benefits
* Alternative Benefit Plans
* Alternative Benefit Plan Eligibility
* Designing an Alternative Benefit Plan
* Autism Services
* Behavioral Health Services
* Parity
* Substance Use Disorders
* Children and Youth
* SUPPORT Act Innovative State Initiatives and Strategies
* SUPPORT Act Provider Capacity Demonstration
* State Planning Grants for Qualifying Community-Based Mobile Crisis
Intervention Services
* Dental Care
* Early and Periodic Screening, Diagnostic, and Treatment
* Vision and Hearing Screening Services for Children and Adolescents
* Lead Screening
* Hospice Benefits
* Mandatory & Optional Medicaid Benefits
* Prevention
* Telemedicine
* Prescription Drugs
* Prescription Drugs
* Branded Prescription Drug Fee Program
* Drug Utilization Review
* Federal Upper Limit
* Medicaid Drug Policy
* Medicaid Drug Rebate Program
* Pharmacy Pricing
* Program Releases
* Retail Price Survey
* State Drug Utilization Data
* State Prescription Drug Resources
* Long Term Services & Supports
* Long Term Services & Supports
* Health Homes
* Person-Centered Hospital Discharge Model
* Person-Centered Planning Grants
* State Profile Tool Grant
* Balancing Long Term Services & Supports
* Integrating Care
* Employment Initiatives
* Institutional Long Term Care
* Money Follows the Person
* PACE
* Alternatives to Psychiatric Residential Treatment Facilities
Demonstration
* Reports & Evaluations
* Self-Directed Services
* Testing Experience & Functional Tools demonstration
* Workforce Initiative
* CHIP
* CHIP
* Benefits
* Eligibility Standards
* Eligibility Standards
* Waiting Periods
* Cost Sharing
* Financing
* CHIPRA
* CHIPRA
* CHIPRA Awards & Performance Bonus
* CHIP State Program Information
* Reports & Evaluations
* CHIP Managed Care
* CHIP Quality & Performance
* Basic Health Program
* State Overviews
* State Overviews
* Scorecard
* Scorecard
* National Context
* State Health System Performance
* State Administrative Accountability
* Federal Administrative Accountability
* State Profiles
* Medicaid MAGI & CHIP Application Processing Time
* About Us
* About Us
* Messages from CMCS
* Beneficiary Resources
* Visit CMS
* Contact Us
* Program History
* Leadership
* Organization
Search
* Search
* Archive
* Site Map
* FAQs
Learn How to Apply for Coverage
Comment or View Pending Demonstrations
Medicaid & CHIP Scorecard
NEW & NOTABLE
* State Release 189- Technical Guidance - Value Based Purchasing (VBP)
Arrangements for Drug Therapies using Multiple Best Prices ( PDF, 317.36 KB )
Mar 23, 2022
* Manufacturer Release 116- Technical Guidance - Value Based Purchasing (VBP)
Arrangements for Drug Therapies using Multiple Best Prices ( PDF, 312.18 KB )
Mar 23, 2022
* CMS releases two new planning tools for the eventual resumption of routine
Medicaid, CHIP, and BHP operation Mar 21, 2022
* Medicaid Program: Final and Preliminary Disproportionate Share Hospital
Allotments and Final and Preliminary Institutions for Mental Diseases
Disproportionate Share Hospital Limits Mar 14, 2022
* Medicaid & CHIP and the COVID-19 Public Health Emergency: Preliminary
Medicaid & CHIP Data Snapshot for Services through August 31, 2021 ( PDF,
2.13 MB ) Mar 04, 2022
See All
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The U.S. Department of Health and Human Services (HHS) is responding to an
outbreak of respiratory disease caused by a novel (new) coronavirus named
“Coronavirus Disease 2019” (abbreviated “COVID-19”).
Outbreaks of novel virus infections among people are always of public health
concern. This is an ongoing situation and we will continue to update.
FIND OUT MORE ON MEDICAID AND CHIP COVERAGE AND BENEFITS RELATED TO COVID-19
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