In January 2009, CMS published a notice delaying for 60 days the effective date of a November 25, 2008 final rule designed to provide state Medicaid agencies with increased flexibility to impose premium and cost sharing requirements on certain Medicaid recipients. On March 27, 2009, CMS further delayed the effective date until December 31, 2009. In addition, CMS reopened the comment period on the November rule until April 27, 2009. CMS is especially interested in comments on the effect of certain provisions of the American Recovery and Reinvestment Act of 2009 (ARRA or Recovery Act) involving premiums and cost sharing on the CMS policy.