The Centers for Medicare & Medicaid Services (CMS) recently rescinded Biden era guidance related to the coverage of health-related social needs (HRSN) services and supports in Medicaid and the Children’s Health Insurance Programs (CHIP). CMS has defined HRSNs as “an individual’s unmet, adverse social conditions that contribute to poor health outcomes,” such as homelessness.
Under the Biden administration, CMS had issued two Informational Bulletins (November 2023 and December 2024) which outlined opportunities for Medicaid and CHIP “to cover clinically appropriate and evidence-based services and supports that address HRSN.” A third guidance document — the “HRSN Framework” — was also published in 2021. The HRSN Framework outlined services and supports that CMS considered “allowable” under its section 1115 demonstration waiver authority.
All three guidance documents were rescinded by the Trump administration in March. Moving forward, CMS will consider states HRSN-related waiver requests “on a case-by-case basis to determine whether they satisfy federal requirements” without reference to the prior guidance.