The West Virginia Department of Human Services (DoHS) is encouraging Medicaid members to stay informed as new federal Medicaid requirements are scheduled to take effect in 2027.
The changes stem from federal legislation and guidance issued by the Centers for Medicare & Medicaid Services (CMS), which requires certain adults enrolled in Medicaid to meet community engagement requirements as a condition of eligibility beginning January 1, 2027.
"Federal law has changed, and our responsibility is to ensure West Virginians have accurate information and understand how these changes may affect them," said Christy Donohue, DoHS Commissioner of the Bureau for Medical Services. "We want Medicaid members to know that DoHS is on track to implement these requirements and is working to make the process as simple as possible."
While implementation remains months away, DoHS has been preparing for these changes and is committed to providing clear, timely information to Medicaid members, providers, and community partners throughout the process.
DoHS remains on schedule to meet key federal implementation deadlines, including the October 1, 2026, deadline for eligibility changes affecting certain non-citizen categories and the January 1, 2027, deadline for community engagement requirements.
To support implementation, the Department is enhancing its eligibility systems to automate verification and eligibility processes whenever possible. These improvements are designed to reduce administrative burden, streamline case processing, and make it easier for both Medicaid members and staff to navigate the new requirements. Whenever available, electronic data sources will be used to automatically verify information, reducing the need for members to submit additional documentation.
To help members navigate upcoming changes, DoHS has launched WVMedicaidHelp.org. This dedicated website provides information about community engagement requirements, exemptions, frequently asked questions, and future updates as additional federal guidance becomes available.
The website serves as the primary source of information for Medicaid members and their families regarding these upcoming changes.
At this time, Medicaid members should:
- Ensure their mailing address, phone number, and email address are up to date.
- Read any communications received from DoHS regarding Medicaid eligibility.
- Visit WVMedicaidHelp.org for updates and information.
- Watch for additional communications regarding any actions that may be required before January 1, 2027.
