CMS Re-Establishes Data Match With OPM for Marketplace and Medicaid Eligibility Verification
CMS has re-established a Privacy Act matching program with the Office of Personnel Management to verify minimum essential coverage through OPM health benefit plans. The data match enables CMS and State Administering Entities to determine eligibility for qualified health plans through exchanges and insurance affordability programs, including Medicaid and CHIP. The match supports initial eligibility determinations, renewals, redeterminations, and appeals. Effective July 29, 2026, this routine data exchange ensures states can verify coverage status when individuals apply for Medicaid or marketplace subsidies.
State Medicaid agencies rely on this OPM data match to accurately verify applicants' existing coverage and prevent inappropriate enrollment or subsidy payments, making it a core operational tool for eligibility systems.
CHIP · Managed Care
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