New CMS Guidance on Addressing Social Needs Through Medicaid

Implications for States, Managed Care, and Health Systems

In January 2023, CMS published new guidance to help states enhance and expand their efforts to address health-related social needs of Medicaid enrollees through a category of services known as “in lieu of a service or setting” (ILOS). This guidance—along with other recent changes to waivers, regulations, and requirements—adds nationwide momentum to efforts to integrate health and social care and reduce inequities for people covered by Medicaid. The guidance is also timely, as states, plans, and providers prepare for the anticipated ending of the federal COVID-19 public health emergency and with it, the potential loss of Medicaid coverage for millions of Americans and increase in unmet social needs.

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