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Proposed Rule Streamlines Medicaid, CHIP Enrollment

An Aug. 31 rule from the Centers for Medicare & Medicaid Services (CMS) proposes to facilitate Medicaid and Children’s Health Insurance Program (CHIP) enrollment and continuous coverage by removing administrative barriers, automating the renewal process, and updating outdated record-keeping regulations.

Part of a larger CMS initiative to improve enrollment processes, the proposed rule targets improving the enrollment and renewal procedures for:

  • medically needy individuals;
  • beneficiaries dually eligible for Medicaid and Medicare; and
  • beneficiaries whose eligibility is based on being 65 or older, blindness, or disability.

Notably, renewals can be conducted no more than once every 12 months for individuals exempt from the Modified Adjusted Gross Income county rules. The proposed rule also:

  • establishes clear process for beneficiaries transitioning between Medicaid and CHIP;
  • provides guidelines for states to check available data before terminating eligibility;
  • prohibits annual and lifetime limits on CHIP benefits; and
  • proposes timelines for states to complete renewals.

Comments are due Nov. 7.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions

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About the Author

Julie Kozminski is a senior policy analyst at America's Essential Hospitals.

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