10 Things for States to Know About the Final Eligibility Rules
May, 2012
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Issue BriefThe Centers for Medicare and Medicaid Services (CMS) published the Final and Interim Final rule on eligibility changes under the Affordable Care Act (ACA) to Medicaid and CHIP on March 23, 2012. And shortly thereafter on March 27, 2012, CMS published the Exchange establishment Final and Interim final rule that includes eligibility requirements for exchanges.
The Treasury Department has yet to release final rules that are expected to include important provisions about the advance premium tax credit (APTC), which are not included in the CMS eligibility rules or our review. In reviewing the eligibility provisions of these rules, NASHP set out to identify the 10 things states should know as they prepare eligibility and enrollment systems, policies and procedures for 2014. This brief is not intended to summarize the rules, but instead is meant to highlight 10 major changes from prior rules and current policy that states will need to understand to implement new eligibility systems effectively. The interim provisions for which CMS is currently soliciting feedback, as well as a number of areas where further federal guidance is still expected are at the top of our list because the comment period for both rules closes on May 7, so states should act quickly to provide input to CMS.
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