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February 2023Vol. 24, No. 1Letter Provides Guidance to States on SUPPORT Act Requirements

The Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services released a letter regarding changes made through the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act (Pub. L. No. 115-271). The SUPPORT Act would expand the mandatory Medicaid eligibility to individuals who were in foster care from other states and simplify eligibility determinations and enrollment processes for this population. The guidance in this letter provides states and stakeholders with new information regarding the effective date and requirements for the new requirements outlined in the SUPPORT Act.

Currently, youth who were formerly in foster care in a state other than their state of residence were not eligible to be part of the mandatory Medicaid eligibility group. The modified SUPPORT Act would deem these youth eligible for Medicaid if they were receiving Medicaid while in foster care in any state, after meeting all other eligibility requirements. In addition, the new guidance would allow youth formerly in care to be eligible for the mandatory Medicaid group even if they also meet requirements for another mandatory eligibility group as long as they are not enrolled in the other group.

These changes apply exclusively to individuals who turn 18 years old on or after January 1, 2023, and meet the following additional requirements:

  • Are under age 26
  • Are not enrolled in an eligibility group described in section 1902(a)(10)(A)(i)(I)-(VII) of the Social Security Act (even if they meet the eligibility requirements for such group)
  • Were in foster care under the responsibility of any state upon attaining age 18 (or such higher age as the state has elected in its title IV-E plan)
  • Were enrolled in Medicaid in any state while in such foster care

Read the letter to learn more about these important modifications to the SUPPORT Act.