Included in the Consolidated Appropriations Act of 2023 were provisions that allowed states to resume Medicaid eligibility terminations in April of 2023 along with data reporting requirements. CMS has used these data or failure to report these data to determine that states are unjustly terminating thousands of individuals from Medicaid for administrative or paperwork reasons.
In response, CMS released an interim final rule on December 4th, codifying CMS’ ability to enforce state compliance by imposing corrective action plans, levying fines, suspending procedural disenrollments, or decreasing a states’ federal financial participation (FMAP). These steps could be taken for a multitude of reasons including failure of a state to submit required reporting, comply with corrective action plan submission, or follow actions outlined in an approved corrective action plan. The rule was effective December 6th and can be reviewed here.
