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CMS Provides Guidance on Medicaid, CHIP Coverage of HRSN Services

Faridat Animashaun
November 28, 2023

A new informational bulletin from the Centers for Medicare & Medicaid Services (CMS) outlines opportunities under Medicaid and the Children’s Health Insurance Program (CHIP) to cover services and supports for health-related social needs.

Along with the Nov. 16 bulletin, CMS published a framework of clinically appropriate and evidence-based services and supports for HRSN that the agency would allow under Medicaid and CHIP authorities, including state plan authorities, section 1915 waivers, managed care in lieu of services and settings, and Section 1115 demonstrations.

CMS said state Medicaid and CHIP programs can help beneficiaries stay connected to coverage and access needed health care services by meeting HRSN. Medicaid-covered services and supports for HRSN would be in addition to, rather than in lieu of, the work or funding of another federal or state non-Medicaid agency and must complement existing social services, such as those provided by other government agencies.

Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.

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