.

CMS is sending monthly reports to states on Medicaid and CHIP enrollees whose immigration status or citizenship can’t be verified by federal agencies.

The Centers for Medicare and Medicaid Services said on Tuesday that it was stepping up efforts to enforce eligibility requirements for Medicaid and the Children’s Health Insurance Program.

CMS will begin sending monthly reports to each state’s Medicaid and CHIP programs that identify enrollees who are unverifiable through federal systems. The system, first reported by CMS officials, is one of the Trump administration’s most aggressive moves yet to address the question of illegal immigrants and eligibility for the taxpayer-funded programs.

Under the new system, reports will be sent to the states identifying enrollees with unverifiable citizenship or immigration status. In addition to Medicaid and CHIP, databases including those from the Social Security Administration and the Department of Homeland Security’s Systematic Alien Verification for Entitlements program will be used.

CMS said the first of those reports was sent to states on Tuesday.

Each state will get its own report throughout the month and will have to conduct reviews on the unverifiable cases. CMS will then ask those states to report back on whether they have determined their enrollees are eligible.

“Today, we are strengthening oversight of enrollment to protect taxpayer dollars and ensure these critical programs only serve those who are eligible by law,” HHS Secretary Robert F. Kennedy Jr. said in a statement.

CMS Administrator Dr. Mehmet Oz said that the move will “protect taxpayer dollars and preserve the integrity of these safety-net health programs so they can continue to support eligible individuals and families who depend on them.”

Oz continued: “Every dollar misspent is a dollar diverted from an eligible, vulnerable person in need of Medicaid and CHIP. This action reaffirms our commitment to program integrity, protecting taxpayer dollars, and ensuring federal benefits are reserved for those who are eligible under the law.”

Push for Immigration Eligibility

The move to more aggressively verify the immigration status of those on Medicaid and CHIP comes as President Donald Trump has taken several steps this term to address illegal immigrants’ use of public benefits.

One of his first executive orders of his second term, issued in February, called on federal agencies to review all benefit programs and take steps to prevent illegal immigrants from receiving taxpayer-funded money in contravention of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

In the months since, the Department of Health and Human Services has also updated a list of federal programs that are considered public benefits. The department’s previous list counted 31 programs, but the list of public programs was increased to 44 in a later update.

Judicial Challenges, State Lawsuits

Tuesday’s CMS announcement is the latest in a spate of rulemaking by the federal government that is tying public benefit programs to immigration enforcement. In recent months, courts have intervened in a number of those initiatives.

Last month, a federal judge ordered the Department of Health and Human Services to cease sharing enrollee information with immigration officials. The administration had recently passed the information to ICE to assist in their deportation efforts, but a court ruled that the practice was beyond the department’s statutory authority.

States, meanwhile, are now under new legal obligations to the Republicans’ congressional spending legislation. The bill, passed last month, also requires states to conduct eligibility checks on Medicaid beneficiaries at least twice a year. It was a significant increase from the previous expectation, and supporters say it is necessary to ferret out fraud and abuse.

Opponents say the new measures are an unnecessary hassle for some of the country’s most vulnerable families.

A group of more than two dozen Democratic attorneys general have sued the Trump administration over those new requirements. Led by New York Attorney General Letitia James, the coalition argues that the rules mandating the verification of immigration status on federally funded programs will harm the states’ ability to serve millions of their residents.

“States like New York have long built health, education, and family support systems that serve anyone in need,” James said last month. “These programs work because they are open, accessible, and grounded in compassion. Now the federal government is pulling that foundation out from under us overnight, jeopardizing cancer screenings, early childhood education, primary care, and so much more. This is a baseless attack on some of our country’s most effective and inclusive public programs, and we will not let it stand.”

CMS Efforts Continue, but State Lawsuits Await

CMS says its latest effort is necessary to prevent fraud and abuse on the country’s Medicaid and CHIP systems. The federal spending bill requires the states to conduct checks twice a year, something the CMS move will help them do.

The first batch of CMS reports to the states has already been sent, but the legal challenge to the administration on these and other rules is still ongoing.

CMS sent out notices in April for the new system and is beginning to send the new reports.

The next round of state reviews is not due until October, but the lawsuit filed by James and the attorneys general in New York, New Mexico, Vermont, California, and elsewhere is still ongoing.

CMS sent out notices in April about the changes and has already begun sending the new reports.

James and other state officials have until September 9 to respond to the court’s ruling against the Trump administration’s prior attempt to make the verification process mandatory.