CMS Rule Changes for Case Management

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CMS has proposed new rules for case management for Targeted Case Management that it has indicated will also apply to case management offered under other authorities, such as 1915(c) waivers and Medicaid administrative match.  Below we present documents and links to assist states in addressing this quickly changing issue.

This site is intended to facilitate states’ ability to understand this issue.  Please email us any additional documents or links that you think would be helpful.

Guidance Provided by CMS

• Interim Final Rule on Targeted Case Management (TCM) Published December 4, 2007

• CMS Fact Sheet on Medicaid Definition of Covered Case Management Services Issued November 30, 2007

• CMS Presentation on TCM Rate Setting

• CMS Guidance on TCM Rate Setting

• Questions and Answers on Rule Dated April 14, 2008

• Sample document developed by CMS to assist the States in assessing the implications of the changes on their State Plan and determining whether any amendments or other administrative actions are necessary

• CMS website page providing guidence on TCM rules

• Notice of Moratorium on TCM Rules

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