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Page 19 – CMCS Informational Bulletin In addition to an individual who is a specified excluded individual for part or all of a month in which they would otherwise be required to demonstrate community engagement, other individuals are excepted from demonstrating community engagement and are similarly not subject to community engagement requirements for that month. These individuals include those who for part or all of a month in which they would otherwise be required to demonstrate community engagement are: under the age of 19; entitled to, or enrolled for, benefits under Medicare Part A, or enrolled for benefits under Medicare Part B; or described in any of the mandatory eligibility groups listed in subclauses (I) through (VII) of section 1902(a)(10)(A)(i) of the Act. Additionally, individuals are excepted for a month in which they are otherwise required to demonstrate community engagement, if, at any point during the three-month period ending on the first day of that month, they were an inmate of a public institution. States also have the option to implement an exception for persons who experience one of the following short-term hardship events: receiving inpatient hospital services or certain other types of medical care; residing in a locality where there is a Presidential declaration of a disaster or emergency; residing in a locality with an unemployment rate over certain thresholds; or needing to travel outside of their community for an extended period of time, for themselves or their dependents, to receive treatment of a serious or complex medical condition where such treatment is not available within the individual’s community of residence. There are several ways an applicable individual can demonstrate community engagement for a month, including through a combined minimum of 80 hours of work, community service, and/or participation in a work program, or enrollment in an educational program at least half-time, among others. States must require that applicable individuals seeking Medicaid coverage meet community engagement requirements for at least one month but not more than three consecutive months immediately preceding the month during which the individual applies. States must require current beneficiaries to meet the requirements for one or more months (consecutive or not) during the period between the individual’s most recent eligibility determination and their next regularly scheduled redetermination. A state may opt to conduct more frequent verifications of compliance with community engagement requirements. Generally, to verify compliance with, or an exception to, or exclusion from community engagement requirements, states must establish processes and use reliable information available to the state, without requiring individuals to submit additional information, where possible. If a state cannot verify an applicable individual’s compliance with the community engagement requirements, it must provide notice of noncompliance and allow the applicant or beneficiary (as applicable) 30 calendar days to demonstrate compliance or show that the requirement does not apply to them. If no satisfactory showing of compliance or inapplicability of the requirement is made, the state must determine whether the individual has any other basis for eligibility for Medicaid or another insurance affordability program. The state must then provide written notice and fair hearing rights in accordance with 42 C.F.R. part 431 subpart E (including advance notice in the case of an eligibility termination or other adverse action) and, if there is no other basis for