Public Health & Policy
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Medicaid
— Agency is offering states discounted and free tech products to help
by Joyce Frieden, Washington Editor, MedPage Today
January 29, 2026 • 5 min read
WASHINGTON — Are you worried about how your Medicaid patients are going to comply with the new Medicaid work requirement? CMS said Thursday they’re going to try to make it as easy as possible — for states and for enrollees.
“We need better collaboration … between the federal government, states, and innovators, and most importantly, we need a better beneficiary experience,” Dan Brillman, director of CMS’s Center for Medicaid and CHIP Services, said Thursday at a press conference at HHS. “This is really also for states, but it’s not just about the savings. It’s how we as a country work efficiently together to … support beneficiaries in their path to prosperity while improving their well-being and economic mobility.”
Under the so-called “community engagement” requirements that were part of the reconciliation bill passed by Congress in July — a bill that also included nearly $1 trillion in cuts to the Medicare program — Medicaid recipients are required to demonstrate at least 80 hours of engagement per month in employment; participation in a work program, such as job training; enrollment in an educational program (at least half time); community service activities; or a combination of these activities. The requirements take effect on Jan. 1, 2027.
To help states implement this, CMS explained in a press release that companies that currently support state Medicaid systems have pledged to offer states more than $600 million in no-cost and significantly discounted technology products and services to support community engagement implementation. For example, Brillman said at the briefing, “several [vendors] are providing no-cost integrations with SNAP [the Supplemental Nutrition Assistance Program] and Medicaid … That means we’re going to automate the compliance for Medicaid community engagement when someone is already compliant with SNAP work requirements.”
“And so when you can automate that process, that takes the person out of the process as well,” Brillman said. “And so when they’re utilizing multiple benefits like SNAP and Medicaid, where there is a big overlap, we can automate tons of those processes for states and do that at no cost.”
The savings for each state could be significant, Brillman said. “Most states think this was going to cost between $3 million and $10 million for them to implement [the work requirement]. And the [reconciliation bill passed last July] provided anywhere from $2 million to $20 million per state for grants to implement the ‘community engagement’ requirements.”
The offers from the vendors include “a lot of no-cost offers for cloud-based software, which we greatly support,” he said. “And we’re going to see $2 million fixed fees or under,” which will help states that are trying to figure out how they’re going to invest their funding from the congressional legislation.
The contracts vendors are offering aren’t just for a single year, but instead are good through 2028. “That provides predictability for states so that they can better long-term invest in innovation, and not just make incremental changes to systems that don’t necessarily improve the beneficiary experience,” Brillman said.
Some of the vendors and their offerings include:
Conduent: Discounted professional services and systems integration costs for work requirement implementation will be provided over the next 3 years. Conduent also has pledged to offer its artificial intelligence-driven fraud tool at no cost to states; that tool “identifies individual applications that are most at risk of being fraudulent applications based on a variety of data sets. This will be delivered at a discounted price of $2M per state in one-time implementation costs.”
Deloitte: Existing Medicaid clients will receive no-cost installation in Year One for Deloitte’s eligibility verification software, plus discounted data-source subscriptions and discounted integration fees through 2028.
Maximus: The company’s Community Engagement Tracking Tool includes a service portal, mobile app, and Interactive Voice Response System; the mobile-first portal is intended to help enrollees prove they’re meeting community engagement requirements by documenting time they worked or attended educational courses or volunteered, and helps some enrollees apply for an exclusion from the requirements. For Maximus’ existing Medicaid eligibility and enrollment state clients, there will be no cost for the development of the tool or for licensing and maintenance through 2028, and fees to deploy the tool will be discounted.
CMS has learned from states’ previous efforts to implement work requirements, officials said at the briefing. For example, rather than having to periodically prove that they are continuing to comply with work requirements — something that was difficult for Medicaid enrollees in Arkansas who didn’t have internet access — beneficiaries can enter their community engagement information once “and then we can continue to [automatically] query,” said Amy Gleason, strategic advisor to CMS. “As long as they have that same job, or they’re in the same school, we can continue to do that without them having to repeatedly do it.”
CMS Administrator Mehmet Oz, MD, MBA, said at the briefing that stopping fraud — whether it’s committed by companies or individuals — was one of his particular concerns. “In South Florida, there are 20 times more DME [durable medical equipment] providers than McDonald’s, which I didn’t believe initially, but I went there, and it’s remarkable,” Oz said. “And many times they’re clustered together at the same address, not billing anything … They don’t actually ship any products. They have no people working there. There’s nothing in the office. And what they do is create fictional bills, send them out … They get paid within a couple weeks. By the time we find out that they billed us $5 million, the money is gone.”
“These are often multinational criminal organizations that also do money laundering and are involved in a bunch of different criminal activities, banking fraud,” he continued. “They just come to healthcare, because this agency is a massive target … We estimate it could be up to $100 billion of this type of fraud, which we intend to claw back, because these are vulnerable Americans who are losing access to care” from the money that’s being lost.
