2. Assessing Compliance for Applicants

At new § 435.556(a)(1), we implement the requirement under section 1902(xx)(1)(A) of the Act that, for an applicable individual, the State must require the individual to demonstrate community engagement as a condition of eligibility at application. Specifically, the State must require an applicable individual who files an application for medical assistance under the State plan (or a waiver of such plan) to demonstrate community engagement for at least 1 but not more than 3 consecutive months, as specified by the State, immediately preceding the month of application. At application, the review period is the State-specified number of months prior to the month of application for which someone must demonstrate community engagement. We interpret the requirement to mean that at a minimum, States must require applicable individuals to demonstrate community engagement in the 1 month prior to the month of application. However, States may elect to extend this review period to 2 or 3 consecutive months prior to the month of application. An applicable individual who files an application is considered to have successfully met the requirement if they demonstrate community engagement for all of the months elected by the State. States must specify the number of consecutive months for which an applicable individual must demonstrate community engagement prior to the month of application in the State plan.

We acknowledge that assessing compliance with the community engagement requirement will necessitate changes to existing application processes and procedures. As States consider the changes that are necessary to implement this requirement, States may need to consider how these changes affect the application process, including the paper and online applications, overall timelines, and workflows. States will need to make the necessary adjustments to ensure efficient eligibility and enrollment operations and compliance with processes for all Medicaid populations.