Issue Briefs | Apr 12, 2012

Overview of Final Medicaid Eligibility Regulation

Manatt Health Solutions

On March 16, 2012, the Department of Health and Human Services (HHS) issued final and interim final rules codifying Medicaid eligibility and enrollment provisions of the Patient Protection and Affordable Care Act (ACA). The rules address Medicaid eligibility categories, expansion of Medicaid eligibility for non-disabled adults, modernization of eligibility verification rules, streamlining Medicaid and Children’s Health Insurance Program (CHIP) applications and renewals, and coordinating eligibility across Medicaid and CHIP. This policy brief, prepared by Manatt Health Solutions, gives a high level overview of important highlights, focusing on key areas where HHS has changed or expanded upon the proposed Medicaid rules published on August 17, 2011. It then provides a section-by-section summary of the regulations.


Expert Perspectives

September 26, 2023

CMS Finalizes Medicaid Rule to Streamline Enrollment into Medicare Savings Programs

This expert perspective provides a high-level overview of key provisions included in the “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment” final rule that will facilitate enrollment and retention of Medicare Savings Program (MSP) coverage. MSPs are state-run programs that help low-income Medicare enrollees pay their Medicare premiums and/or cost-sharing. While the final rule’s effective date is November 17, 2023, CMS delayed compliance dates for most provisions until April 1, 2026, to reflect states’ competing priorities in light of the “unwinding” of the Medicaid continuous coverage requirement.

Government Shutdown Implications for Health Programs and Personnel

As congressional negotiations continue to stall on fiscal year 2024 appropriations, federal agencies are deep into contingency planning for a potential government shutdown beginning October 1. Decisions are still being made about which federal activities and personnel are considered essential. This expert perspective describes the plans currently available from the Department of Health and Human Services and the implications for health programs and personnel.