Base
Rule2026-110942026-06-03

Medicaid Program; Community Engagement Requirement for Certain Individuals

Health and Human Services Department, Centers for Medicare & Medicaid Services

Abstract

This interim final rule with comment period (IFC) interprets and implements the community engagement requirement in Medicaid under section 1902(xx) of the Social Security Act. States are required to implement the new requirement no later than January 1, 2027. This IFC specifies the requirements and expectations for States, including the Medicaid applicants and beneficiaries who must demonstrate community engagement as a condition of their eligibility, the types of qualifying activities that satisfy the community engagement requirement, the criteria to meet an exception from the requirement (that is, be deemed compliant), and the criteria to meet a specified exclusion from the requirement. It also specifies requirements for verification of qualifying activities, outreach to affected populations, steps States must take if they determine individuals are noncompliant, and additional operational considerations for States. Finally, this IFC specifies implementation timing and establishes new State reporting requirements.

Action & Dates

Action
Interim final rule with comment period.
Dates
Effective date: These regulations are effective on July 31, 2026.
Effective Date
2026-07-31

CFR References

Topics

Administrative practice and procedureAid to Families with Dependent ChildrenCitizenship and naturalizationCivil rightsGrant programs-healthHealth careHealth facilitiesHealth insuranceIndividuals with disabilitiesIntergovernmental relationsMedicaidMedicarePenaltiesPrivacyReporting and recordkeeping requirementsSex discriminationSupplemental Security Income (SSI)Wages

Public Comment

Document Excerpt

Document Headings Document headings vary by document type but may contain the following: the agency or agencies that issued and signed a document the number of the CFR title and the number of each part the document amends, proposes to amend, or is directly related to the agency docket number / agency internal file number the RIN which identifies each regulatory action listed in the Unified Agenda of Federal Regulatory and Deregulatory Actions See the Document Drafting Handbook for more details. Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 431, 435, 438, 457, and 600 [CMS-2454-IFC] RIN 0938-AV98 ( printed page 33348) AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: Interim final rule with comment period. SUMMARY: This interim final rule with comment period (IFC) interprets and implements the community engagement requirement in Medicaid under section 1902(xx) of the Social Security Act. States are required to implement the new requirement no later than January 1, 2027. This IFC specifies the requirements and expectations for States, including the Medicaid applicants and beneficiaries who must demonstrate community engagement as a condition of their eligibility, the types of qualifying activities that satisfy the community engagement requirement, the criteria to meet an exception from the requirement (that is, be deemed compliant), and the criteria to meet a specified exclusion from the requirement. It also specifies requirements for verification of qualifying activities, outreach to affected populations, steps States must take if they determine individuals are noncompliant, and additional operational considerations for States. Finally, this IFC specifies implementation timing and establishes new State reporting requirements. DATES: Effective date: These regulations are effective on July 31, 2026. Comment date: To be assured consideration, comments mus

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Full Document

Citation: 91 FR 33348