CMS issues State Medicaid Director Letter on Maintenance of Effort Provisions

CMS released a letter providing guidance on “the maintenance of effort” (MOE) provisions in the Affordable Care Act (ACA) of 2010.  Some states have been seeking ways to avoid the ACA’s MOE – the requirement to maintain their current Medicaid eligibility criteria and services until 2014. The letter and the enclosed Q&As address the ACA’s MOE provisions for Medicaid and the Children’s Health Insurance Program (CHIP) generally. It also answers specific questions related to the non-application of the MOE provisions for certain adult populations in States with a budget deficit, section 1115 waivers and demonstration projects, and the treatment of premiums.  Click here for the press release. See the letter at

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