Consolidated Appropriations Act, 2023

The Consolidated Appropriations Act, 2023, (CAA, 2023) (P.L. 117- 328), signed into law by Congress on December 29, 2022, includes Sections 5121 (mandatory) and 5122 (optional) to address Medicaid and the Children's Health Insurance Program (CHIP) requirements for certain beneficiaries who are incarcerated.

Section 5121 of the CAA amends the Social Security Act (the Act) and describes a mandatory population (eligible juveniles and targeted low-income children) and a set of pre-release and post-release services. These provisions took effect on January 1, 2025. Massachusetts has elected to begin implementation of the mandatory requirements of Section 5121, as feasible, which include the following:

Screening and Diagnostic Services

Section 5121 requires that any screenings and diagnostic services that meet reasonable standards of medical and dental practice, as determined by the state, or as otherwise indicated as medically necessary, in accordance with the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements (including a behavioral health screening or diagnostic service) be provided to post-adjudication eligible juveniles in public institutions (i.e., youth or adult carceral facility) in the 30 days prior to their release (or not later that one week, or as soon as practicable, after release from the public institution).

Targeted Case Management

Section 5121 also requires targeted case management services be provided to post-adjudication eligible juveniles 30 days pre-release and for at least 30 days post-release.

Eligible Juveniles

An eligible juvenile is an individual who is under 21 years of age who was determined eligible for any Medicaid eligibility group, or an individual determined eligible for the mandatory eligibility group for former foster care children, immediately before becoming an inmate of a public institution or while an inmate of a public institution. For more eligibility information, see SHO #24-004.

Implementation of CAA Section 5121

To assist correctional facilities with the provision of screening and diagnostic services to eligible youth under the CAA, MassHealth has developed the following resources:

• MassHealth Consolidated Appropriations Act Section 5121 Medical Screening Schedule: PDF | Word
  • This resource provides a list of preventive health screening components to be performed and/or reviewed by medical staff. 
• Clinical Guidance and Best Practices on Screening and Diagnostic Services for CAA Section 5121 Eligible Youth: PDF | Word
  • This resource provides detailed written descriptions of each component of the screening schedule, as well as details on the dental components, not listed on the medical screening schedule. 

Additional guidance letters released by CMS:

• SHO 24-004: Provision of Medicaid and CHIP Services to Incarcerated Youth
• SHO-24-006: Provision of Medicaid and CHIP Services to Incarcerated Youth - FAQs

Date published:	April 2, 2025