WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) announced a new oversight initiative aimed at ensuring that enrollees in Medicaid and the Children’s Health Insurance Program (CHIP) meet federal citizenship and immigration status requirements. The effort underscores the agency’s push to strengthen program integrity and ensure taxpayer-funded benefits are directed only to those legally eligible.
As part of the initiative, CMS will provide states with monthly enrollment reports identifying individuals whose citizenship or immigration status could not be verified through federal databases, including the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program. States will be required to review each flagged case, request additional documentation if necessary, and take appropriate action, which may include adjusting coverage or enforcing non-citizen eligibility rules.
“Medicaid is a lifeline for vulnerable Americans — and I will protect it from abuse,” said U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr. “We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law.”
State Responsibilities and Federal Monitoring
CMS is sending the first set of reports to states beginning today, with all states expected to receive their initial reports within the next month. States are tasked with reviewing identified cases promptly and taking corrective steps where necessary.
CMS Administrator Dr. Mehmet Oz emphasized the agency’s focus on protecting resources for those who qualify. “Every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP,” Oz said. “This action underscores our unwavering commitment to program integrity, safeguarding taxpayer dollars, and ensuring benefits are strictly reserved for those eligible under the law.”
Impact on Benefits and Services
Under federal law, individuals without satisfactory immigration status are generally ineligible for full Medicaid or CHIP benefits but may qualify for limited emergency medical services under certain circumstances. The new initiative seeks to ensure that states comply with federal eligibility rules while preserving resources for qualified beneficiaries.
Commitment to Program Integrity
CMS stated that it will closely monitor state compliance on a monthly basis and maintain oversight to ensure that corrective actions are implemented where necessary. The initiative reflects the agency’s broader goals of promoting transparency, enforcing eligibility standards, and preserving the long-term stability of Medicaid and CHIP.
By tightening oversight and supporting state-level enforcement, CMS aims to uphold the integrity of these programs while ensuring that assistance remains available for eligible low-income families, children, and individuals who rely on Medicaid and CHIP for essential health care services.
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