Regulatory Advisory

CMS Releases Proposed Rule on Medicaid Eligibility under the ACA

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule implementing a number of provisions regarding Medicaid eligibility under the Affordable Care Act (ACA). The proposed rule would establish a structure and options for states to coordinate Medicaid, the Children’s Health Insurance Program, and health exchange eligibility notices and appeals. The proposal provides additional benefits and cost-sharing flexibility for state Medicaid programs, including allowing states to establish higher cost sharing for non-preferred drugs and non-emergency use of emergency departments. The proposed rule also codifies several other provisions required by the ACA, including streamlining new eligibility categories that go into effect in 2014 and modifying Alternative Benefit Plans for newly-eligible low-income adults. Comments on the proposed rule are due by Feb. 13. More information is available in a CMS fact sheet.