CMS Finalizes Rule to Streamline Medicaid and CHIP Enrollment Processes

CMS recently unveiled a finalized rule aimed at enhancing and safeguarding the application, eligibility determination, enrollment, and renewal processes for Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). This rule is designed to eliminate bureaucratic hurdles and streamline access to health care coverage for millions of eligible individuals according to CMS.

The rule, which builds upon the coverage protections established by the Affordable Care Act (ACA), aims to ensure that eligible Americans can easily obtain and maintain their health care coverage without unnecessary red tape. HHS Secretary Xavier Becerra emphasized the importance of removing administrative barriers to enrollment, particularly for children, to uphold the promise of the ACA and expand access to affordable health care.

CMS Administrator Chiquita Brooks-LaSure echoed this sentiment, highlighting the rule’s focus on simplifying processes to facilitate eligible individuals’ connections to health care providers. By standardizing enrollment and renewal procedures nationwide and extending consumer protections to all Medicaid and CHIP enrollees, the rule seeks to make it easier for eligible individuals, including children and adults, to stay covered.

Key provisions of the finalized rule include minimum timeframes for providing additional information during the application and renewal processes. Additionally, it prohibits states from conducting renewals more frequently than every 12 months and from requiring in-person interviews for older adults and people with disabilities.