Executive Order Guidance

Welcome to the Centers for Medicare & Medicaid Services' (CMS) Executive Order Guidance web page. By utilizing this web page, we intend to make it easier for providers, suppliers, and the general public to understand the changes we are proposing or making in the programs we administer (for example, Medicare, Medicaid, and the State Children's Health Insurance Program).

On January 18, 2007, the President issued Executive Order (E.O.) 13422, an Amendment to E.O. 12866 for Regulatory Planning and Review. The primary focus of the E.O. is on improving the way the Federal government does business with respect to “significant” guidance documents – by increasing their quality, transparency, accountability and coordination. Simultaneously, the Office of Management and Budget issued a “Final Bulletin for Agency Good Guidance Practices” that established policies for the development, issuance, and use of significant guidance documents, including requirements for making these documents available for public comment.

To ensure CMS meets the objectives of the E.O. and to keep the public informed of the on-going changes in the various programs, CMS will be publishing updated documents on the executive order guidance web page. This will afford the general public the opportunity to make comments on the documents for CMS' consideration.

The “Downloads” section below lists some particularly important guidance documents recently released by CMS. However, CMS issues thousands of new or revised guidance documents annually and cannot make individual decisions on each as to whether it is “significant” as defined under the Executive Order (e.g., annual effect of $100 million or more on the economy). At present, there are approximately 37,000 documents on the CMS Web site and many, perhaps most of these, include guidance. Interested members of the public can review any of these (whether or not “significant”) using any of the indexing, finding or search aids on the CMS web site. The great majority of these are organized within each of the “Related Links Inside CMS” listed below. We note that there are separate public review processes already established by statute for CMS regulations, coverage decisions, and Paperwork Reduction Act issuances. However, we welcome comment on other issuances as well, and most CMS web pages provide for public feedback.

If you have comments on how CMS is following the Executive Order or Bulletin, you can forward your concerns to the Director, Issuances, Records and Information Systems Group. To submit comments, click on the FAQs link located under Tools at the bottom of the page and then click on the Submit Request link at the top of the page to submit your comment.