On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released comprehensive guidance, accompanied by a summary slide deck, reinforcing and clarifying federal Medicaid requirements regarding Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). This expert perspective provides an overview of CMS’ new EPSDT guidance, which represents CMS’ most comprehensive discussion of EPSDT requirements in over a decade.

State updates as of October 18, 2024.

State updates as of October 11, 2024.

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

State updates as of October 4, 2024.

On April 2, 2024, the Centers for Medicare & Medicaid Services offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. While there are multiple drivers of inequities in oral health, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. This expert perspective provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.

State updates as of September 27, 2024.

On September 20, 2024, CMS issued guidance detailing the timeline and expectations for states to fully comply with federal Medicaid and CHIP renewal requirements. This expert perspective summarizes the guidance, which requires every state to submit by December 31, 2024 a plan (using CMS’ template) that assesses state compliance with the federal renewal requirements and describes the plan for addressing deficiencies to achieve full compliance by December 31, 2026.

State updates as of September 20, 2024.