Issue Brief | Apr 12, 2012

Overview of Final Medicaid Eligibility Regulation

Manatt Health Solutions

On March 16, 2012, the Department of Health and Human Services (HHS) issued final and interim final rules codifying Medicaid eligibility and enrollment provisions of the Patient Protection and Affordable Care Act (ACA). The rules address Medicaid eligibility categories, expansion of Medicaid eligibility for non-disabled adults, modernization of eligibility verification rules, streamlining Medicaid and Children’s Health Insurance Program (CHIP) applications and renewals, and coordinating eligibility across Medicaid and CHIP. This policy brief, prepared by Manatt Health Solutions, gives a high level overview of important highlights, focusing on key areas where HHS has changed or expanded upon the proposed Medicaid rules published on August 17, 2011. It then provides a section-by-section summary of the regulations.