The Centers for Medicare & Medicaid Services (CMS) Division of Tribal Affairs, in collaboration with the CMS Children and Adults Health Programs Group and the State Demonstrations Group, is holding an All Tribes Consultation Webinar Tuesday, June 30 from 12 to 1 p.m. Eastern. The webinar offers an overview of the Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) and State Medicaid Director Letter (SMDL) on Budget Neutrality and Certification by the Chief Actuary of CMS for Section 1115 Medicaid Demonstration Projects.

On June 1, 2026, CMS released an Interim Final Rule with Comment (IFC) that interprets and implements the community engagement requirement in Medicaid under section 1902(xx) of the Social Security Act (the Act) as added by section 71119 of Public Law 119-21 (the Working Families Tax Cut legislation). It also fulfills the requirement for CMS to promulgate an interim final rule to implement these provisions no later than June 1, 2026. For more on how to submit comments and to review the entire rule, visit the Federal Register website.

On June 11, 2026, CMS published an SMDL to give states early notice regarding the changes to budget neutrality at subsection 1115(g) of the Act. CMS is preparing a notice of proposed rulemaking and suggested revisions to 42 CFR part 431 subpart G related to section 1115 demonstration projects. CMS expects to provide additional details, guidance, and technical assistance to states prior to January 1, 2027. Plan to attend the June 30 webinar for a general overview of the IFC and SMDL. Review the fact sheet on the requirement for additional information.