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CMS proposed rule would streamline Medicaid/CHIP enrollment and renewal process

Written on Sep 9, 2022

A new proposed rule would simplify the process for people to enroll and renew coverage in Medicaid, the Children’s Health Insurance Program (CHIP) and Basic Health Programs. 

If finalized, the rule would limit renewals to once every 12 months, allow applicants 30 days to respond to information requests and require consistent renewal processes across states, the Centers for Medicare & Medicaid Services (CMS) said. 

Other proposed changes include: 

  • Removing the requirement to apply for other benefits as a condition of Medicaid eligibility. 

  • Ensuring automatic enrollment of Supplemental Security Income recipients into the Qualified Medicare Beneficiary group, with limited exceptions. 

  • Creating a clear process to prevent termination of eligible beneficiaries who need to be transitioned between Medicaid and CHIP when their income changes or when they’re eligible for the other program. 

  • Allowing CHIP beneficiaries to stay enrolled or re-enroll without a lockout period for failing to pay premiums.  

  • Removing pre-enrollment waiting periods and prohibiting annual and/or lifetime limits on benefits in CHIP. 

  • Cutting references to outdated technology and requiring records to be stored electronically. 

  • Providing specific timelines for states to complete Medicaid and CHIP renewals. 

There will be a 60-day comment period, after which the proposed rule will be reviewed by the U.S. Department of Health and Human Services.