Medicaid Updates

Utah Medicaid Policy Updates

1. Section 71109: Qualified Immigrant List Member Review

  • Utah Medicaid, in close collaboration with the Department of Workforce Services (DWS), will officially begin operational work on compiling and analyzing the member list for Section 71109 (Qualified Immigrant eligibility) on Monday, June 8th.
  • As a reminder, this federal provision narrows the definition of a "qualified immigrant" for full Medicaid/CHIP coverage effective October 1, 2026. We are proactively auditing our systems to identify individuals who may be impacted so we can ensure accurate, timely redeterminations and proper outreach.

Partner action & messaging:

While formal member notices will not go out immediately, we want you to be fully aware that this background work is underway. If your frontline staff or advocates receive inquiries from concerned community members, please utilize the following messaging:

  • Direct to the OBBBA Webpage: Route individuals to Utah Medicaid’s official OBBBA webpage for the most up-to-date, accurate FAQs and resources: medicaid.utah.gov/obbba. 
  • Remind About Emergency Medicaid: Reassure members that even if full scope eligibility changes in the future, Emergency Medicaid coverage remains available to non-citizens who meet the emergency criteria. They can find more information at Utah Medicaid’s Emergency Medicaid website: https://medicaid.utah.gov/emergency-medicaid/.

2. CMS final rule released: Community Engagement Requirements

  • The Centers for Medicare & Medicaid Services (CMS) has officially released its interim final rule regarding Medicaid community engagement requirements.
  • Utah Medicaid is currently reviewing the details of this interim final rule. We are actively working to incorporate these federal parameters into our state implementation plan to ensure that our upcoming rollouts—including tracking, compliance timelines, and member exemptions—align seamlessly with federal guidelines.
  • We are incredibly grateful to have this group as a trusted network to help Utahns navigate these changes smoothly. We will provide a more detailed breakdown of our findings from the CMS rule and the Qualified Immigrant data review at one of our next regular strategy sessions.

Medicaid Members with Unverified Tribal Status

Utah Medicaid Updates & Policy Changes (Fall 2026)

  • This resource from the State of Utah Department of Health and Human Services (DHHS) provides important Medicaid information and guidance regarding upcoming Medicaid changes that will take effect this Fall. The toolkit includes information intended to support staff, partners, and community members in understanding policy updates, eligibility impacts, and available resources related to Medicaid members with unverified tribal status.