CMS Announces Hold Harmless Period for Medicaid Work Requirement Through June 30, 2027
The Centers for Medicare & Medicaid Services (CMS) announced on November 13 an optional hold harmless period through June 30, 2027, for states implementing the Medicaid work requirement. States that adopt the transition period will still assess whether individuals meet the work requirement or qualify for an exclusion, but they will not deny applications or disenroll otherwise eligible individuals solely for failure to meet the requirement.
Under federal law, beginning January 1, 2027, certain Medicaid applicants and beneficiaries ages 19 to 64 must meet a statutory work requirement unless excluded. Qualifying activities include 80 hours per month of work, community service, or participation in a work program; enrollment in an educational program at least half-time; a combination of qualifying activities totaling at least 80 hours per month; or meeting a specified monthly income threshold. CMS set out the details in an interim final rule issued in June 2026.
CMS said the transition period gives states time to further modernize systems, improve processes, and streamline the applicant and beneficiary experience, and to learn from the early months of implementation before enforcement begins. The agency also strongly encouraged states to maximize automated verification using reliable data they already hold, to give people clear and timely notices explaining what has been verified and what is still needed, and to test end-to-end processes before enforcement.
“States have made real progress, and they’ve been clear with us about what it takes to get this right for beneficiaries, at scale and for the long term,” said Dan Brillman, Deputy Administrator and Director of the Center for Medicaid and CHIP Services. “If the state can use data to show that someone is working or qualifies for an exclusion, that person should not have to track down paperwork to prove it.”
Source: Centers for Medicare & Medicaid Services
Published by GSM · USA (original Chinese edition)
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