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The Centers for Medicare and Medicaid Services (CMS) announced Tuesday that it will be sending monthly enrollment reports to each state identifying any Medicaid or Children’s Health Insurance Program (CHIP) enrollees whose immigration or citizenship status could not be verified.

CMS will review federal databases for all individuals enrolled in either program to check their eligibility. Databases include the Social Security Administration’s list of verified numbers and the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program. Any enrollee who appears in Medicaid or CHIP but does not have an active and verifiable number in SAVE or a valid Social Security number will be flagged in each state’s monthly report.

“This information will help states verify eligibility for each person enrolled in Medicaid and CHIP in a manner that prioritizes the privacy and civil rights of Medicaid and CHIP beneficiaries,” the agency stated in a press release. “CMS is moving expeditiously to develop the capacity to provide states with a monthly eligibility mismatch report that they can use to determine whether an individual is eligible to be enrolled in Medicaid or CHIP.”

The first batch of monthly reports will be sent to states on Tuesday, according to CMS. Each report will be reviewed by state agencies, and they will have the option to contact the individual identified in the federal databases to verify their citizenship or immigration status.

States will then report back to CMS on how many cases were verified. Enrollment in both Medicaid and CHIP will be terminated for individuals who do not meet eligibility requirements.

“We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,” Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said in a statement.

CMS Administrator Dr. Mehmet Oz also stressed the need for increased oversight in order to protect the two programs.

“Maintaining the integrity of these programs is our top priority. Every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP,” Oz said in a statement. “Today’s action underscores our steadfast commitment to program integrity, protecting taxpayer dollars, and ensuring benefits are available only for those eligible under the law.”

CMS efforts to identify and remove immigrants who are ineligible for either Medicaid or CHIP are part of the Trump administration’s renewed effort to cut illegal immigrants from federal programs. President Donald Trump, who is seeking re-election, signed an executive order in February of last year that sought to expand the scope of means-tested benefit programs available only to citizens. The executive order asked agencies to consult with the Domestic Policy Council to identify ways they identify illegal immigrants and deport them from the country.

Two months later, HHS added to the number of programs it considered to be public benefits. The department expanded its list from 31 programs to 44 programs, which may now be considered in the verification process for safety-net health programs.

CMS plans to stop at monthly reports. However, states will be required to conduct eligibility checks on all Medicaid recipients at least twice a year starting July 2025. The provision, which was part of Republican spending legislation passed in March, requires states to use available tools such as the SAVE program to verify individual immigration and citizenship status.

A federal judge last month ordered HHS to stop sharing Medicaid enrollee information with immigration authorities. The Trump administration had begun sharing the data with Immigration and Customs Enforcement (ICE) to assist in deportation efforts. The court ruled that ICE did not have the authority to share such information with ICE. The ruling means it could take much longer for each state to complete its reporting requirements with CMS.

Opponents of increased oversight have taken the Trump administration to court. A coalition of more than 20 attorneys general, led by New York’s Letitia James, has argued that mandatory verification of immigration status for federally funded programs threatens the viability of these programs in their states.

James, a Democrat, pointed to the large number of public benefits New York and other states have built up since the early 1990s. A number of benefits, such as local housing assistance or early childhood education, were expanded to include anyone in need of these services. States will have to restructure their public benefit offerings and may have to cut programs altogether to comply with new federal requirements, the lawsuit argues.

“This is a baseless attack on some of our country’s most effective and inclusive public programs, and we will not let it stand,” James said. “Our communities cannot and will not return to the dark days before many of these lifesaving and life-giving services existed. We will fight to preserve them.”