Streamlining MSP Eligibility and Enrollment

Washington State Health Care Authority sent this bulletin at 01/13/2026 03:35 PM PST

January 13, 2026

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Streamlining Medicare Savings Program (MSP) Eligibility and Enrollment

Low-Income Subsidy Program (LIS)

When a person is eligible for Medicare, they can apply for Medicare Part D LIS program with the Social Security Administration (SSA). In 2023, CMS released a final rule (2023-20382) to streamline the eligibility determination and increase enrollment into MSP by utilizing the LIS leads data.

H.R.1 impacts to streamlining MSP

H.R.1 put a moratorium on enforcing the final rule. The 2010 Medicare Improvements for Patients and Providers Act (MIPPA) requires states to use LIS leads data for MSP enrollment. A decision was made to implement the final rule and use LIS leads data as an application for MSP.

LIS leads data as MSP application

Current process - When the state receives a person's LIS data, a letter of request for information is sent along with the MSP application for the client to complete.

New Process - When the state receives a person's LIS data, it is treated as the MSP application. No additional verification is required unless the information is not compatible with the LIS file.

Future state

The state receives the LIS file and attempts to match the client with Automated Client Eligibility System (ACES) information.
Beginning January 19, 2026, the LIS file will be treated as an application for MSP.
Clients will be given 30 days to respond to a request for information.
Clients who are conditionally approved will be given 90 days to post eligibility verification.
If the client has an active or pending MSP, no further action is required.

Click here for more information about Streamlining MSP Eligibility and Enrollment

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About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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