Notice2025-20911
Notice of Medicaid Information Sharing Between the Centers for Medicare & Medicaid Services and the Department of Homeland Security
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Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 25, 2025
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This notice announces that the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), will share certain information with the U.S. Department of Homeland Security (DHS), and its component agency, U.S. Immigration and Customs Enforcement consistent with federal laws requiring the provision of information to DHS.
Full Text
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<title>Federal Register, Volume 90 Issue 225 (Tuesday, November 25, 2025)</title>
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[Federal Register Volume 90, Number 225 (Tuesday, November 25, 2025)]
[Notices]
[Pages 53324-53326]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-20911]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9163-N]
Notice of Medicaid Information Sharing Between the Centers for
Medicare & Medicaid Services and the Department of Homeland Security
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: This notice announces that the Department of Health and Human
Services (HHS), Centers for Medicare & Medicaid Services (CMS), will
share certain information with the U.S. Department of Homeland Security
(DHS), and its component agency, U.S. Immigration and Customs
Enforcement consistent with federal laws requiring the provision of
information to DHS.
DATES: This notice is applicable immediately.
FOR FURTHER INFORMATION CONTACT: The Center for Medicaid and CHIP
Services at <a href="/cdn-cgi/l/email-protection#efaca2acbcaf8c829cc187879cc1888099"><span class="__cf_email__" data-cfemail="6a292729392a09071944020219440d051c">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
I. Background
This notice provides information regarding the provision of certain
information collected by the Department of Health and Human Services
(HHS), Centers for Medicare & Medicaid Services (CMS), with U.S.
Department of Homeland Security (DHS) and its component agency U.S.
Immigration and Customs Enforcement (ICE). CMS partners with states to
administer Medicaid. In doing so, CMS collects information regarding
individuals for a variety of purposes related to administration,
oversight, and program integrity. This notice applies to data collected
by CMS in connection with its role in the Medicaid program.
CMS receives information related to immigration status because it
is relevant to the Medicaid program. For example, under Medicaid,
states are prohibited from claiming federal financial participation
(FFP) for ``medical assistance furnished to an alien who is not
lawfully admitted for permanent residence or otherwise permanently
residing in the United States under color of law.'' Section 1903(v)(1)
of the Social Security Act (the Act) (42 U.S.C. 1396b(v)(1)). The
exception to this prohibition is that FFP can be paid if the care and
services are ``necessary for the treatment of an emergency medical
condition of the alien,'' the alien otherwise meets the eligibility
requirements for Medicaid, and the care and services are not related to
an organ transplant procedure. Section 1903(v)(2) of the Act (42 U.S.C.
1396b(v)(2)).
Federal laws govern the collection, use, and disclosure of CMS
information. Depending on the type of information, applicable laws may
include the Privacy Act of 1974 (5 U.S.C. 552a), section 1106(a) of the
Act (42 U.S.C. 1306(a)(1)) and CMS implementing regulations at 42 CFR
part 401, subpart B, and other federal laws. In addition, CMS has
established a robust privacy and security program (<a href="https://security.cms.gov/topic/privacy">https://security.cms.gov/topic/privacy</a>). CMS has previously stated on its
website that the information regarding individuals that it collects
will only be used for administration of its programs. See, e.g., CMS,
CMS Privacy Home Page, <a href="https://www.cms.gov/about-cms/information-systems/privacy">https://www.cms.gov/about-cms/information-systems/privacy</a> (``To protect your privacy, we'll tell you before we
collect any personal information we need to run our health care
programs, and only use it for that purpose.''). CMS also has stated on
its website that it will not use immigration status for immigration
enforcement purposes. See CMS, More information for immigrant
households, <a href="https://www.healthcare.gov/immigrants/immigrant-families/">https://www.healthcare.gov/immigrants/immigrant-families/</a>
(``We won't use any immigration status you share with us for
immigration enforcement purposes.''). This policy statement was made in
the context of and in reliance on a 2013 ICE policy that stated that
ICE would not use CMS data or information provided by individuals to
obtain coverage for certain benefits under CMS programs as the basis
for pursuing a civil immigration enforcement action. ICE has rescinded
this policy.\1\ See ICE Policy Memorandum 11066.2, Use of HHS
Information and Rescission of ICE Policy Memorandum 11066.1,
Clarification of Existing Practices Related to Certain Health Care
Information (October 25, 2013, 2013 Policy Memorandum), (Oct. 27, 2025,
ICE Policy Memorandum 11066.2).
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\1\ ICE notes that it is currently precluded from using this
information due to a Preliminary Injunction and it will proceed with
this policy when the Preliminary Injunction is lifted. See ICE
Policy Memorandum 11066.2, see also California v. HHS, No. 25-05536
(N.D. Cal. filed July 1, 2025). Under that same Preliminary
Injunction, CMS is currently precluded from sharing certain Medicaid
data with ICE for immigration enforcement purposes. Similarly, CMS
will proceed with this policy when the Preliminary Injunction is
lifted.
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II. Legal Authority
Several federal laws authorize CMS to make certain information
available to
[[Page 53325]]
DHS. See ICE Policy Memorandum 11066.2.
<bullet> Under the Homeland Security Act of 2002, the Secretary of
Homeland Security shall have access to information ``relating to
matters under the responsibility of the Secretary that may be
collected, possessed, or prepared by an agency of the Federal
Government as the President may further provide.'' 6 U.S.C. 122(a)(2).
Additionally, the Secretary of Homeland Security can obtain this
information upon request and can enter into cooperative agreements with
other agencies to provide DHS officials with access to the data on a
regular or routine basis, including requests or arrangements involving
broad categories of material, access to electronic databases, or both.
6 U.S.C. 122(b).
<bullet> Under the Immigration and Nationality Act, ``[a]ny
information in any records kept by any department or agency of the
Government as to the identity and location of aliens in the United
States shall be made available to'' immigration authorities. 8 U.S.C.
1360(b). This ``expansive'' language reaches ``broad[ ] swaths of
information'' in the possession of the federal government. United
States v. California, 921 F.3d 865, 892 (9th Cir. 2019).
Moreover, under 8 U.S.C. 1373, ``[n]otwithstanding any other
provision of Federal, State, or local law, a Federal, State, or local
government entity or official may not prohibit, or in any way restrict,
any government entity or official from sending to, or receiving from,
[DHS] information regarding the citizenship or immigration status,
lawful or unlawful, of any individual.'' 8 U.S.C. 1373(a).
Additionally, ``[n]otwithstanding any other provisions of Federal,
State, or local law, no person or agency may prohibit, or in any way
restrict, a Federal, State, or local government entity'' from
transmitting, maintaining, or exchanging information regarding
immigration status with any other Federal, State, or local government
entity. 8 U.S.C. 1373(b).
<bullet> The Privacy Act of 1974 does not provide authority for a
disclosure. However, with respect to U.S. citizens and lawful permanent
residents, an exception in the law would not require an agency to
obtain prior written consent of the individual to whom the record
pertains to disclose a record contained in a system of records to
another federal agency ``for a civil or criminal law enforcement
activity if the activity is authorized by law, and if the head of the
agency has made a written request to the agency which maintains the
record specifying the particular portion desired and the law
enforcement activity for which the record is sought,'' See 5 U.S.C.
552a(b)(7).\2\
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\2\ The Privacy Act of 1974 only applies to U.S. citizens and
lawful permanent residents. See 5 U.S.C. 552a(a)(2) (defining
individual to include U.S. citizens and lawful permanent residents).
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III. Purpose of Information Sharing
This notice announces CMS policy that CMS will provide certain
information to ICE upon request from ICE consistent with federal laws
to advance administration priorities related to immigration laid out in
the following Executive Orders.
<bullet> Executive Order 14159, ``Protecting the American People
Against Invasion''--The purpose of this Executive Order is to ``ensure[
] that the Federal Government protects the American people by
faithfully executing immigration laws of the United States.'' (90 FR
8443, January 29, 2025).
<bullet> Executive Order 14165, ``Securing Our Borders''--This
Executive Order establishes a policy of the United States ``to take all
appropriate action to secure the borders of our Nation'' through a
range of means, including deterring and preventing the entry of illegal
aliens into the United States, and removing promptly all aliens who
enter or remain in violation of Federal law. (90 FR 8467, January 30,
2025).
<bullet> Executive Order 14218, ``Ending Taxpayer Subsidization of
Open Borders''--This Executive Order directs federal agencies to
faithfully carry out the immigration laws and ``to ensure, to the
maximum extent permitted by law, that no taxpayer-funded benefits go to
unqualified aliens.'' (90 FR 10581, February 25, 2025).
<bullet> Executive Order 14243, ``Stopping Waste, Fraud, and Abuse
by Eliminating Information Silo''--One of the purposes of this
Executive Order is to promote inter-agency data sharing. It directs
agencies to ``take all necessary steps, to the maximum extent
consistent with law,'' to ensure access to information ``for purposes
of pursuing Administration priorities related to the identification and
elimination of waste, fraud, and abuse.'' (90 FR 13681, March 25,
2025).
As noted by ICE in ICE Policy Memorandum 11066.2, certain
information held by CMS is useful for immigration enforcement purposes
and to support the full and efficient execution of ICE's mission. ICE
Policy Memorandum 11066.2 at 4. This CMS information ``represents a
particular set of accurate and quality data that can be used to enhance
ICE's data and improve its law enforcement actions.'' Id. More broadly,
using CMS information as detailed in the ICE Policy Memorandum 11066.2
``allows ICE to more efficiently achieve its mission of preserving
national security and public safety.'' Id.
IV. Information To Be Shared
ICE announced that, at this time, it contemplates requesting from
CMS available biographical, contact, and location information, though
ICE reserved the right, in a specific case, to consider requesting
other information on a case-by-case basis as permitted by law. Id. at
2. This CMS information may include Medicaid information or data shared
with CMS by states. CMS will share the minimum required information
with ICE, giving due consideration to the information requested by ICE,
the federal laws that govern the provision of information to DHS and
the CMS information requested, the capabilities of CMS systems, and the
CMS resources available to respond to ICE information requests.
Examples of information that CMS may share with ICE include the
following: citizenship and immigration status, location, and phone
numbers, and, in specific cases, other information on a case-by-case
basis as permitted by law. CMS will respond to requests made by ICE and
will transfer any information to ICE in a secure manner and establish
appropriate safeguards for the information provided, including through
written agreements or other arrangements with ICE.
CMS intends its provision of various categories of information to
be severable from each other. For instance, CMS's provision of
biographical information about aliens is severable from its provision
of location information about aliens or from its provision of other
types of information that ICE does not presently intend to request for
immigration enforcement purposes. In the event a court finds that ICE
does not have a right to access a specific type of data (or that CMS is
not authorized to provide such data), CMS intends that the provision of
specific categories of data be severable from each other.
V. Reliance Interests
CMS has considered the fact that states, providers, beneficiaries,
health insurance issuers, other regulated entities, and the general
public may have relied on past CMS statements that information
collected by CMS would only be used for program administration purposes
and would not be used for immigration enforcement purposes. The CMS
statements were made against the backdrop of federal laws that
authorize
[[Page 53326]]
CMS to share information with DHS, upon request, and a policy choice
made by ICE not to use certain information as the basis for pursuing a
civil immigration enforcement action. These federal laws have long
apprised the regulated public that immigration authorities have access
to ``broad swaths'' of information possessed by other federal agencies
relevant to immigration enforcement. Brief of Appellee State of
California in United States v. California, No. 18-16496, 2018 WL
5880015 (9th Cir. Nov. 5, 2018) (``When Congress has intended to reach
broad swaths of information, or specifically a person's address, it has
used different words. For example . . . the INA requires federal
agencies to communicate to ICE, upon request, `[a]ny information in any
records . . . as to the identity and location of aliens,' [8 U.S.C.
1360(b).]'')); see also Policy Memorandum 11066.2 at 4. To ensure that
the public is aware that CMS intends to disclose certain information to
DHS consistent with federal laws, including available information
contained in program eligibility information, CMS is publishing this
notice and will update relevant websites to reflect that federal laws
authorize CMS to share certain information with DHS.
ICE determined, as stated in ICE Policy Memorandum 11066.2, that
the ``value of this information to immigration and criminal law
enforcement operations outweighs any relevant reliance interests.'' ICE
Policy Memorandum 11066.2 at 4. Pursuant to the 6 U.S.C. 122(a)-(b), 8
U.S.C. 1360(b), and 8 U.S.C. 1373, ``ICE has always had authority to
request and receive information for immigration enforcement purposes.''
ICE Policy Memorandum 11066.2 at 5.
As ICE stated, ``[t]he statutory provisions that both give ICE the
right to request this information, and that require aliens to
affirmatively provide that information to ICE upon request, are
longstanding, and there is no exception to their application under
Medicaid.'' ICE Policy Memorandum 11066.2 at 6.
Given the longstanding legal requirements for aliens to apprise
immigration authorities of their whereabouts, whatever reliance states,
providers, beneficiaries, health insurance issuers, other regulated
entities, and the general public have placed on DHS's exercise of its
enforcement discretion and CMS's information not being shared with
immigration authorities due to that exercise of discretion is entitled
to little to no weight. The biographical and location information that
ICE intends to seek from CMS is information that ICE has long had a
right to access. Accordingly, any interests in not sharing this
information with ICE are greatly diminished and outweighed by ICE's
legitimate law enforcement interests.
Moreover, while some states and providers contend that it would be
detrimental to public health if aliens do not partake in federal health
benefits for which they are eligible (for example, federally funded
Medicaid services for emergency medical conditions) because if CMS
shares information with ICE, the legal requirements regarding
information sharing with ICE long predate restrictions on Medicaid to
unqualified aliens. Compare, e.g., 8 U.S.C. 1360(b) (enacted in
Immigration and Nationality Act, 66 Stat. 163, 234 (1952)), with 42
U.S.C. 1396b(v)(1), 8 U.S.C. 1611(b)(1)(A) (enacted in Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, 110
Stat. 2105, 2180). The concerns of states and providers are entitled to
little to no weight because they reflect the scheme that Congress
created, which provides benefits to aliens under certain limited
circumstances and gives immigration authorities the right to access
information that arises from the conferral of those benefits.
Finally, to the extent that states provide data to CMS on aliens
who receive health benefits or services funded only by the state,
states are doing so voluntarily. CMS only requires states to submit
data associated with beneficiaries who receive federally-funded
Medicaid services. It is incumbent upon the states to separate the data
that they collect when submitting it to CMS. Any reliance interests
with respect to the population of aliens who receive health benefits or
services funded only by states are entitled to no weight since states
are not required to submit this information to CMS.
VI. Additional Information
Although notice and comment is unnecessary for this statement, CMS
has been explicitly instructed by the district court in California v.
HHS, No. 3:25-cv-05536 (N.D. Cal.), to address its reasons for forgoing
notice and comment.
As explained above, CMS's prior policy statement that it would not
use CMS data or information for immigration enforcement purposes was
made in the context of ICE's prior policy, as described in its 2013
Policy Memorandum, to exercise its enforcement discretion to abstain
from requesting information from CMS as the basis for pursuing a civil
immigration enforcement action. CMS's prior policy statement did not
change legal norms, as described above, created by Congress.
This notice communicates a CMS policy that CMS will share certain
information consistent with federal law authorizing such sharing with
respect to requests for CMS information from DHS and ICE. CMS is
accordingly updating its policy statement in this regard. CMS is
publishing this notice solely to inform interested parties of its
decision to provide information to ICE consistent with federal law.
This is, at the most, a policy statement as defined by 5 U.S.C.
553(b)(A) and (d)(2) and is exempt from notice and comment for that
reason alone. See Perez v. Mortgage Bankers Ass'n, 575 U.S. 92, 95
(2015) (not all rules must be issued through notice and comment,
including interpretive rules and general statements of policy under
section 4(b)(A) of the Administrative Procedure Act.).
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Mehmet Oz, having reviewed and approved this document,
authorizes Evell Barco Holland, who is the Federal Register Liaison, to
electronically sign this document for purposes of publication in the
Federal Register.
Evell Barco Holland,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2025-20911 Filed 11-21-25; 11:15 am]
BILLING CODE 4120-01-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.