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Healthy Adult Opportunity State Guidance

On January 30, 2020, the Center for Medicaid and CHIP Services (CMCS) issued a State
Medicaid Director Letter that provided guidance to state Medicaid agencies on a new “Healthy
Adult Opportunity.” This guidance described a range of options for states, including using
Section 1115 demonstration authority to set additional conditions of Medicaid eligibility,
establish additional premiums and cost-sharing, and adopt alternative demonstration financing
for participating states.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 16, 2025

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.