CMS Proposes Changes to Streamline Medicaid, CHIP, and Basic Health Program 

Last week, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would make changes to simplify the processes for eligible individuals to enroll and retain eligibility in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. This proposed rule would remove barriers and facilitate enrollment of new applicants, particularly those dually eligible for Medicare and Medicaid; align enrollment and renewal requirements for most individuals in Medicaid; establish beneficiary protections related to returned mail; create timeliness requirements for redeterminations of eligibility in Medicaid and CHIP; make transitions between programs easier; eliminate access barriers for children enrolled in CHIP by prohibiting premium lock-out periods, waiting periods, and benefit limitations; and modernize recordkeeping requirements to ensure proper documentation of eligibility and enrollment. Medicaid is an important source of health care coverage for rural America, covering nearly a quarter of individuals under age 65 living in rural areas. Of interest to rural stakeholders, CMS is seeking comment on whether States either should be permitted or required to update beneficiary contact information based on information obtained from specific groups including providers like Federally Qualified Health Centers and Rural Health Clinics.


Comments are due by November 7th.