CMS to cut red tape for Medicaid, CHIP enrollment in final rule

CMS finalized new rules that are intended to eliminate barriers to Medicaid and CHIP access. 

The final rule, published March 27, will eliminate annual and lifetime limits for CHIP coverage and bar states from locking children out of CHIP benefits if their families are unable to pay premiums. 

The rule will also: 

  • Eliminate waiting periods for CHIP coverage and improve the transfer of children from Medicaid to CHIP 
  • Require states to provide individuals 15 days to provide documents when applying for Medicaid for the first time, and 30 days for renewals 
  • Prohibit states from conducting eligibility renewals more than once every 12 months, and ban in-person interview requirements for older Medicaid beneficiaries and those with disabilities 

The rule was first proposed in September 2022. 

According to KFF, more than 19 million people have been disenrolled from Medicaid since April 2023, when states began redetermining beneficiaries' eligibility for the first time since the onset of the COVID-19 pandemic. Of those disenrolled, most have had their coverage terminated for procedural reasons, rather than being determined ineligible. 

"This historic rule will simplify the process for people who are eligible for our nation's healthcare programs to maintain their connection to their healthcare providers," CMS Administrator Chiquita Brooks-LaSure said in a news release. "It means less time and money spent on unnecessary processes and more effort dedicated to protecting vital coverage for eligible people." 

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