Clarification of Terms Implicating the Spousal Relationship in Regulations and Guidance for Medicare- and Medicaid-certified
Providers and Suppliers.
• Clarification of “Spouse” & Related Terms: The Centers for Medicare and Medicaid Services (CMS) is clarifying that the terms
“spouse”, “marriage,” “relative,” and “family,” as well as other terms that implicitly or explicitly implicate the spousal
relationship, such as (but not limited to) “representative,” “support person,” “surrogate,” and “next-of-kin,” include all
marriages lawful where entered into, including lawful same-sex marriages, regardless of the certified provider’s or supplier’s
location or the jurisdiction in which the spouse lives.
• Advance Copy: Interpretive Guidance for Appendices A, AA, M, W, PP, and Y: Attached is an advance copy of revisions to the
State Operations Manual (SOM), Appendices A, AA, M, PP, W, and Y, incorporating this clarification.