Today, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) Letter that provides guidance to support states in implementing the mandatory reporting requirements outlined in the Mandatory Medicaid and Children’s Health Insurance Program (CHIP) Core Set Reporting final rule released on August 31, 2023. This initial annual subregulatory guidance details the requirements and expectations for compliance with mandatory annual state reporting of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set) and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set). Mandatory reporting requirements apply to all states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. American Samoa and the Mariana Islands may, but are not required to, report Child and Adult Core Set measures.
This SHO includes guidance on:
- Mandatory reporting regulations and adherence to reporting guidance;
- Core Set measures for which reporting is mandatory in 2024;
- The populations that must be included in reporting and the population exemption process;
- Categories of stratified data that must be reported in or before 2025;
- Measures subject to stratification in 2025;
- Attribution rules; and
- The Child and Adult Core Set State Plan Amendment.
SHO: Initial Core Set Mandatory Reporting Guidance
More information on Children's Health Care Quality Measures. More information on Adult Health Care Quality Measures.
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