Federal Register #2026-22015

HHS and CMS health coverage eligibility and enrollment data-matching program

HHS and CMS announced a data-matching program with participating state entities to support health coverage eligibility and enrollment checks. - Government participants: U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), and participating State-Based Administering Entities (AEs). - Program purpose: Support eligibility decisions for Qualified Health Plans, Medicaid, the Children’s Health Insurance Program (CHIP), and Basic Health Programs (BHPs); verify Medicaid community engagement; and help prevent concurrent Medicaid enrollment across states through the Multi-State Enrollment Prevention system. - Data exchange: CMS and participating AEs will exchange eligibility-related records through the CMS data services hub. - Procurement status: This is a program notice, not a solicitation or award. No products, services for purchase, quantities, OEMs, or commercial vendors are identified.

Description

HHS and CMS give notice of a computer matching program between CMS and participating State-Based Administering Entities (AEs), titled “Determining Eligibility for Enrollment in Applicable State Health Subsidy Programs Under the Patient Protection and Affordable Care Act.” The program supports eligibility determinations for state health subsidy programs, including Qualified Health Plans, Medicaid, CHIP, and Basic Health Programs. It also supports Medicaid community engagement requirements and prevents concurrent Medicaid enrollment in multiple states through the Multi-State Enrollment Prevention system. The notice invites comments by November 30, 2026; the program has an initial term of 18 months and may be renewed for up to one additional year under stated conditions.

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