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The Centers for Medicare and Medicaid Services (CMS) on Tuesday said it is expanding new surveillance efforts of Medicaid and the Children’s Health Insurance Program (CHIP) with the goal of identifying and reporting monthly to every state about enrollees who are ineligible based on citizenship or immigration status. CMS officials first told Politico about the move last week, making it one of the Trump administration’s most comprehensive efforts to date to limit public health insurance enrollment to U.S. citizens and lawful residents.

CMS, which administers Medicaid and CHIP for state and territorial governments, will start with its first report on Tuesday. Going forward, according to the CMS, every state will receive an enrollment report every month with a “list of enrollees for whom Medicaid programs have not received or been able to confirm citizenship or immigration status using federal databases. Databases the CMS will check include Social Security Administration records as well as DHS’s Systematic Alien Verification for Entitlements (SAVE) program.

CMS Administrator Dr. Mehmet Oz released a statement on the action, describing it as part of the department’s efforts to root out waste, fraud, and abuse from the two safety-net programs. “We’re committed to making sure taxpayer dollars go to those who are eligible, and every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP,” Oz said. “We can’t stand by and allow this to continue. I have a deep and abiding obligation to use the tools we have to combat fraud and abuse.”

The Trump administration has ramped up immigration-related restrictions on Medicaid and CHIP in recent weeks, as it has also ordered new restraints on public benefits access in other social services. In a February executive order, Trump called on all agencies to make administrative adjustments to ensure they were not allowing non-citizens to receive federal benefits, specifically referencing requirements from the 1996 Personal Responsibility and Work Opportunity Reconciliation Act. The Trump administration also expanded the types of benefits considered federal benefits in the Spring, increasing eligibility requirements across the board.

CMS came under fire last month for sharing information about enrollees in Medicaid and CHIP with Immigration and Customs Enforcement (ICE). The administration had passed along data to immigration enforcement for deportation purposes, but a federal judge ruled in a case brought by a coalition of Democratic attorneys general that the practice went beyond the department’s authority. The Trump administration has also been moving to lower the bar for denying people from receiving public benefits based on information on state Driver’s License records.

States will now also be obligated by statute to follow through on this reporting because of Republican-passed spending legislation in the Spring. States will now have to verify Medicaid enrollment at least twice a year, a marked increase from the prior requirement. States that fail to meet the biannual requirement could face financial penalties from CMS.

Democrats are already suing the administration over its requirements to verify immigration status for federally funded public benefit programs in several states. New York Attorney General Letitia James said at the time the requirement “threatens access to critical services for millions of people in our states and across the country.”

CMS Must Submit Monthly Reports on Medicaid, CHIP Ineligibles to All States Under New Reporting System – MedCityNews (tinyurl.com/kcmsmonthly) was originally published in Health and Medicine on July 19, 2023, by Patrick Hedger.