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Page 33 – CMCS Informational Bulletin Appendix E. Moratorium on Implementation of Rule Relating to Eligibility and Enrollment in Medicare Savings Programs MSP Final Rule Provisions Subject to Moratorium (Do Not Apply During Moratorium) CMS is prohibited from implementing, administering, or enforcing the policies described below until the moratorium ends on September 30, 2034. States should refer to the Code of Federal Regulations in effect as of November 16, 2023, for requirements under the below-listed rules while the moratorium is in effect. Regulation Description of Provision as Amended by the Medicare Savings Programs (MSP) Final Rule 42 CFR § 406.21(c)(5) Requires group payer states to start Qualified Medicare Beneficiary (QMB) eligibility group coverage for certain individuals as early as the month of Medicare Part A entitlement. 42 CFR § 435.4 Defines Medicare Part D Low Income Subsidy (LIS) Application data (“leads data”) as data the Social Security Administration (SSA) electronically transmits to state Medicaid agencies in accordance with section 1144(c) of the Act. NOTE: The statutory requirements described in section 1144(c) of the Act remain in effect. 42 CFR § 435.601(e) Requires states to include at the least the individuals described in the Medicare Part D LIS definition of family size at 42 CFR 423.772 when determining the “family of the size involved” for MSP income eligibility. 42 CFR § 435.911(e) Codifies in regulation statutory requirements described in section 1935(a)(4) of the Act for states to receive LIS leads data from SSA and to treat such receipt as an application for the MSP eligibility groups and establishes new requirements for states to make MSP eligibility determinations without re-verification when possible. NOTE: The statutory requirements described in section 1935(a)(4) of the Act remain in effect for states. 42 CFR § 435.952(e) Requires states to reduce documentation individuals must provide to verify the value of certain income and resources (i.e., dividend and interest income, non-liquid resources, burial funds and life insurance) when making MSP eligibility determinations. MSP Final Rule Provisions Excluded from Moratorium (Current Rules Apply) CMS is not prohibited from implementing, administering, or enforcing the policies described below. States should refer to the current Code of Federal Regulations for requirements, including while the moratorium is in effect. Regulation Description of Provision as Amended by the Medicare Savings Programs (MSP) Final Rule 42 CFR § 435.909(a) Moves pre-existing requirements for auto enrollment of certain individuals into Medicaid in states that have agreements with the Social Security Administration under 1634 of the Act from paragraph (b) of 435.909 to paragraph (a). 42 CFR § 435.909(b)(1) Requires states to automatically enroll most Medicare-eligible supplemental security income (SSI) recipients into the QMB eligibility group, effective October 1, 2024. 42 CFR § 435.909(b)(2) Created an option for group payer states to automatically enroll SSI recipients who lack premium-free Medicare Part A into the QMB eligibility group, effective November 17, 2023.