Overview
- A coalition of 25 states and the District of Columbia filed a federal lawsuit in Massachusetts on Monday asking a judge to stay or vacate key parts of the June 3 CMS interim final rule.
- The complaint says the rule rewrites the law by requiring a condition to “significantly impair” a person’s ability to work to qualify as medically frail and by limiting when self-attestation will be accepted.
- Plaintiffs argue the rule violates the Administrative Procedure Act and the Constitution’s Spending Clause and requests immediate relief because states face an August 31, 2026 deadline to notify beneficiaries and a January 1, 2027 start date for enforcement.
- States say CMS surprised them after they built IT systems, notices and staffing plans around earlier guidance, and they warn the rule’s added documentation and verification steps will cause eligible people to lose coverage and strain hospitals.
- No court decision has been issued yet and the lawsuit names HHS and CMS leadership as defendants, so the next steps to watch are the agencies’ legal response and whether a judge blocks the rule before states must send notices.