CMS Proposes Restrictive Definition Of Medical Frailty In New Medicaid Work Requirements Rule

In the interim final rule for Medicaid community engagement requirements for the Medicaid expansion population, the Centers for Medicare & Medicaid Services (CMS) proposed a standardized, but restrictive, definition for medical frailty that regardless of diagnosis is tied to the individual’s ability to work or participate in community engagement activities. By January 1, 2027, the 43 states and District of Columbia that expanded Medicaid must ensure that non-exempt beneficiaries ages 19 to 64 are working, volunteering, or engaging in other approved activities for at least 80 hours per month, in order to remain eligible for Medicaid.

The interim . . .