WASHINGTON — The Centers for Medicare & Medicaid Services (CMS) has directed states to begin contacting certain Medicaid beneficiaries by August as part of preparations for new federal work-reporting requirements scheduled to take effect in 2027, according to federal guidance issued this month.
CMS said states must conduct outreach to adults who could be subject to the new Medicaid community engagement requirement before the policy is implemented. The requirement stems from federal legislation enacted in 2025 and was detailed in an interim final rule released on June 1. Under the rule, certain Medicaid beneficiaries will be required to meet work, education, training, or community-service standards as a condition of eligibility beginning Jan. 1, 2027, unless a state adopts the requirement earlier.
The agency said states “must conduct outreach to adults who are already enrolled in Medicaid and could be subject to the requirement prior to implementing the new requirement.” CMS added that states must continue outreach efforts after implementation for new enrollees and those renewing coverage.
According to policy guidance and analyses of the federal rule, states are expected to contact affected beneficiaries between June and August 2026, depending on how each state structures compliance timelines. Outreach must generally occur several months before individuals are required to demonstrate compliance with the new standards.
In a statement accompanying the rule, CMS Administrator Dr. Mehmet Oz said the framework is intended to provide states with a consistent approach for implementing the new requirements. “This rule helps Americans build skills and independence through work, education, job training, or community service,” Oz said.
Federal guidance indicates that outreach notices must explain how beneficiaries can demonstrate compliance, outline potential consequences for failing to meet requirements, and describe available exemptions. Notices are generally required to be sent by mail and through at least one additional communication channel, such as text messages, telephone calls, or online portals.
Health policy organizations and state officials have said outreach will be a significant operational task because millions of Medicaid beneficiaries may need information about whether the new rules apply to them. Several states, including Nebraska and Montana, have already distributed preliminary notices to some enrollees ahead of broader implementation efforts, according to public reports.
The new work-reporting requirement applies to certain adults ages 19 to 64 who are enrolled in Medicaid and do not qualify for specified exemptions, according to CMS. States are generally required to implement the policy by Jan. 1, 2027, while outreach to affected beneficiaries is expected to continue through the second half of 2026.
