With the federal government about to implement a work/community engagement requirement for eligibility for Medicaid coverage, regulators have attempted to define what constitutes “medical frailty” as a reason for exemption from that requirement.
In a new report, KFF explains that a newly adopted rule presenting the Medicaid work/community engagement requirement employs “… a restrictive definition of medical frailty that differs from states’ early expectations” and ties “… medical frailty specifically to the ability to comply with the community engagement requirement (i.e., the ability to work) and prohibiting states from adding categories of individuals to the medical frailty definition.”
KFF also notes that during the first year of the requirement’s implementation – calendar year 2027 – applicants may temporarily, under certain circumstances, self-declare their condition.
Learn more about how the Centers for Medicare & Medicaid Services intends to approach the concept of medical frailty within the context of the new work/community engagement requirement for Medicaid eligibility from the KFF article “CMS Requires More Restrictive Definition of Medical Frailty in New Medicaid Work Requirements Rule,” this CMS news release, and this CMS fact sheet.