States to receive immigration reports on Medicaid enrollees

CMS will start to send states monthly reports identifying individuals with unconfirmed citizenship or immigration status in an effort to combat ineligible Medicaid enrollment.

In an Aug. 19 announcement, the federal agency said the reports are part of an oversight initiative to ensure proper enrollment in Medicaid and the Children's Health Insurance Program (CHIP) based on an individual's legitimate citizenship, national designation or satisfactory immigration status.

The monthly reports will draw on federal databases, including those from the Department of Homeland Security’s Systematic Alien Verification for Entitlements program, to provide states with unconfirmed statuses of residents enrolled in their Medicaid programs.

States must review the cases and verify citizenship or immigration status of the identified individuals. If an enrollee's status cannot be confirmed, states must adjust coverage or enforce noneligibility rules, CMS said in the announcement.

"Medicaid is a lifeline for vulnerable Americans -- and I will protect it from abuse," said HHS 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."

The Trump Administration has made Medicaid program integrity a top priority, homing in on reducing fraud, waste and abuse in the program. In particular, the administration aims to reduce waste by honing Medicaid eligibility and enrollment to ensure only those who qualify receive benefits.

However, undocumented immigrants are not eligible for Medicaid or CHIP. Noncitizens are only eligible if they are lawful permanent residents, or green card holders, refugees and asylees, although some of these populations may have to wait five years before enrolling.

Undocumented immigrants are generally ineligible for federally funded Medicaid. Although some states may offer some Medicaid or Medicaid-like coverage using their own funds. Some immigrants may also qualify for emergency Medicaid, which provides restricted medical coverage for individuals not eligible for full Medicaid benefits but need emergency care.

Emergency Medicaid spending accounts for less than 1% of total Medicaid spending, according to data from KFF. Immigrants under age 65 are also less likely to be covered by Medicaid compared to their U.S.-born citizen peers, KFF reported.

Earlier this year, CMS also increased oversight to prevent states from using federal Medicaid funds to provide non-emergency coverage to undocumented immigrants, threatening to halt funding to states accused of illegally covering this population. CMS also now shares data on immigrant Medicaid enrollees with deportation officials, according to PBS.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.