CMS Releases Guidance on Optional Long-Term Use of Unwinding-Related Section 1902(e)(14) Waivers

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On November 14, CMS released guidance to states on how they can elect to extend permanently many waivers that have given them flexibility in how they conduct eligibility redeterminations for Medicaid and CHIP. The latest Center for Medicaid and CHIP Services Informational Bulletin and accompanying slide deck address the continued use of unwinding-related Section 1902(e)(14) waivers 1 beyond the previously established expiration date of June 30, 2025.

These waivers were originally intended to help states increase ex parte renewal rates, support enrollees with updating their contact information and completing renewal forms, promote continuity of coverage and care, and facilitate the reinstatement of eligible individuals who were disenrolled for procedural reasons during the COVID-19 public health emergency unwinding In an effort to continue supporting state improvements to their eligibility and enrollment systems beyond that unwinding period, CMS evaluated all Section 1902(e)(14) waivers to determine which could be implemented permanently through other federal authorities, given that Section 1902(e)(14) authority is time-limited. As a result, CMS identified other federal authorities for states to continue permanently more than half of the unwinding-related Section 1902(e)(14) waivers. Notably, the flexibilities that had the biggest impact on increasing ex parte rates and maintaining coverage for eligible individuals are now permanently available for states.

[1] Section 1902(e)(14)(A) of the Social Security Act allows for waivers “as are necessary to ensure that states establish income and eligibility determination systems that protect beneficiaries.”

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