DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid
Services 7500 Security Boulevard, Mail
Stop S2-26-12 Baltimore, Maryland
21244-1850

CMCS Informational Bulletin

DATE:

March 4, 2025

FROM:

Drew Snyder, Deputy Administrator and Director
Center for Medicaid and CHIP Services

SUBJECT:    Rescission of Guidance on Health-Related Social Needs

To support implementation of coverage of certain services and supports to address “health-
related social needs” (HRSN) in State Medicaid programs and Children’s Health Insurance
Programs (CHIP), the Center for Medicaid and CHIP Services (CMCS) issued two Center
Informational Bulletins (CIBs). The first, Coverage of Services and Supports to Address
Health-Related Social Needs in Medicaid and the Children’s Health Insurance Program, was
released on November 16, 2023 (November 2023 CIB), and discusses opportunities available
under Medicaid and CHIP to cover certain services and supports that purport to address HRSN.
With the issuance of the November 2023 CIB, CMCS also published a document, Coverage of
Health-Related Social Needs (HRSN) Services in Medicaid and the Children’s Health
Insurance Program (CHIP), which CMS has referred to as the “Framework of Coverage of
HRSN Services in Medicaid and CHIP” or the “HRSN Framework.” The second CIB, released
December 10, 2024, also titled Coverage of Services and Supports to Address Health-Related
Social Needs in Medicaid and the Children’s Health Insurance Program (December 2024
CIB), provided updates and clarifications and superseded both the November 2023 CIB and the
HRSN Framework.

To evaluate policy options consistent with Medicaid and CHIP program requirements and
objectives, CMS is rescinding the November 2023 and December 2024 CIBs. CMS will
consider states’ applications to cover these services and supports on a case-by-case basis to
determine whether they satisfy federal requirements for approval under the applicable
provisions of the Social Security Act and implementing federal regulations, without reference
to the November 2023 and December 2024 CIBs or the HRSN Framework.

CMS is committed to working with states to help identify strategies to support innovation and
improvement in Medicaid and CHIP. If you have questions regarding this bulletin, please
submit them to your State Lead.

