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us/regulation/recovery/release-scope-us-regulation-2026-06-03-cms-2454-ifc-42-cfr-conforming-amendments — release scope us regulation 2026 06 03 cms 2454 ifc 42 cfr conforming amendments · Axiom
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release scope us regulation 2026 06 03 cms 2454 ifc 42 cfr conforming amendments
1. Providing a Notice of Noncompliance
2. Defining “Unable To Verify” Compliance With the Community Engagement Requirement
a. Defining “Unable To Verify” at Application
b. Defining “Unable To Verify” at Renewal
Option 1
Option 2
c. Defining “Unable To Verify” During More Frequent Verifications of Compliance With Community Engagement
Option 1
Option 2
3. Content and Timing of the Noncompliance Notice
4. State Responsibilities When There Is No Satisfactory Showing of Compliance
5. Reenrollment and Reconsideration Periods
6. Noncompliance Procedures and Ensuring Timely Eligibility Determinations at Application
7. Impact of Noncompliance and Eligibility for Financial Assistance for Coverage on a Health Insurance Exchange
K. Implementation Timing
1. Implementation Date
a. Pending Applications and Implementation of the Community Engagement Requirement
b. Community Engagement Requirement for Enrolled Beneficiaries at Implementation
3. Systems Changes Needed To Implement Community Engagement
4. Good Faith Effort Exemption
a. Process and Timing of Requests
b. Criteria for Good Faith Effort Determination
c. Duration of Exemption
d. Reporting Requirements for States Granted Good Faith Effort Exemptions
L. Outreach
M. Managed Care Implications
1. Implications of Community Engagement on Presumptive Eligibility and Presumptive Eligibility Determined by Hospitals
2. Additional Considerations for Section 1115 Demonstrations
O. Monitoring
III. Good Cause for Proceeding With an Interim Final Rule With Comment Period
IV. Collection of Information Requirements
1. States and the Private Sector
2. Beneficiaries
B. Adjustment to State Cost Estimates
C. Information Collection Requirements (ICRs)
1. ICRs Regarding State Requirements To Submit Data for Monitoring Community Engagement (§ 435.562)
a. Performance Indicator Data (Annual Reporting for Monitoring Community Engagement)
b. Eligibility Processing Data (Annual Reporting for Monitoring Community Engagement)
c. T-MSIS Data
2. ICRs Regarding Good Faith Effort Exemptions and Quarterly Reporting (§ 435.560)
3. ICRs Regarding State Plan Amendment (SPA) Submissions To Implement and Confirm Compliance (§ 430.10)
4. ICRs Regarding Verification Plan Submission and Updates (§ 435.557)
5. ICRs Regarding Beneficiary Application Updates (Single Streamlined and Presumptive Eligibility Applications) (§§ 435.912, 435.556, and 435.557)
6. ICRs Regarding Short-Term Hardship Exception Requests (§ 435.555)
7. ICRs Regarding State Requirements for Outreach (§ 435.561) and Noncompliance (§ 435.558).
D. Burden Summary
E. Submission of PRA-Related Comments
A. Statement of Need
B. Overall Impact
1. Benefits
a. Medicaid Applicants and Beneficiaries Subject to the Community Engagement Requirement
2. Costs
a. State and Federal Costs
b. Costs to Medicaid Beneficiaries
a. Impacts on Medicaid Enrollment and Benefit Expenditures
4. Aggregate Time Allocation and Additional Effects on the Federal Deficit
5. Regulatory Review Cost Estimation
D. Alternatives Considered
1. Compliance and Verification Provisions
2. State Implementation
3. Monitoring and Reporting
E. Accounting Statement
F. Regulatory Flexibility Act (RFA)
G. Unfunded Mandates Reform Act (UMRA)
H. Federalism
I. E.O. 14192 , “Unleashing Prosperity Through Deregulation”
J. Conclusion
42 CFR Part 431
42 CFR Part 435
42 CFR Part 438
42 CFR Part 457
42 CFR Part 600
Part 431—state Organization And General Administration
Part 435—eligibility In The States, District Of Columbia, The Northern Mariana Islands, And American Samoa
Community Engagement Requirement
Part 438—managed Care
Part 457—allotments And Grants To States
Part 600—administration, Eligibility, Essential Health Benefits, Performance Standards, Service Delivery Requirements, Premium And Cost Sharing, Allotments, And Reconciliation
Footnotes
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