CMS Finalizes Medicaid Rule to Streamline Enrollment into Medicare Savings Programs

Prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program

On September 18, 2023, the Centers for Medicare & Medicaid Services (CMS) released a final rule, “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment,” which largely maintains—with some modest changes—the Medicare Savings Program (MSP) provisions in the proposed rule that was released on August 31, 2022. The remaining provisions of the August 2022 proposed rule that were focused on streamlining Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment and timeliness standards are slated to be finalized in February 2024.

MSPs are state-run programs that help low-income Medicare enrollees pay their Medicare premiums and/or cost-sharing. In 2017, the Medicaid and CHIP Payment and Access Commission found that only about half of Medicare enrollees eligible for an MSP actually enrolled. CMS estimates that the rule will make Medicare coverage more affordable for 860,000 individuals by making it easier to enroll in an MSP.

In a new expert perspective prepared on behalf of the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health provides a high-level overview of key provisions included in the final rule that will facilitate enrollment and retention of MSP coverage.

To access the full expert perspective, click here.

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