Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland 21244-1850 
 
CMCS Informational Bulletin 
 
DATE:   August 18, 2022 
 
FROM:  Daniel Tsai 
Deputy Administrator and Director 
Center for Medicaid and CHIP Services 
 
SUBJECT:  United States Department of Agriculture (USDA) Demonstration Project to 
Evaluate Using Medicaid Eligibility Data to Directly Certify Children for Free 
and Reduced Price School Meals 
 
The purpose of this CMCS Informational Bulletin is to inform state Medicaid agencies that the 
USDA Food and Nutrition Service (FNS) is issuing a new solicitation for participation in additional 
demonstration projects for states to evaluate the impact of using Medicaid eligibility data to directly 
certify students for free and reduced price school meals. 
  
The Healthy Hunger-Free Kids Act of 2010 amended section 1902(a)(7) of the Social Security Act 
(the Act) to permit Medicaid agencies to enter into data-sharing agreements with state agencies that 
administer the National School Lunch Program and School Breakfast Program.  These data-sharing 
agreements allow the state agencies to directly certify students to receive both free and reduced price 
school meals based on the childs Medicaid eligibility and verified income.  Direct certification has 
the potential to improve student access to school meals, reduce administrative burden for schools and 
families, and improve certification accuracy.  Direct certification cannot be used to negatively 
impact any child already certified for the free and reduced meals programs. 
 
On June 23, 2022, FNS issued a Request for Applications inviting state agencies that administer school 
meal programs to participate in a new demonstration project to evaluate the impact of direct certification 
for  both free and reduced price school meals.  USDA FNS issued previous opportunities for states to 
participate in direct certification demonstrations in 2012, 2016, and 2021.  State Medicaid agencies are 
key partners in these demonstrations, and CMS encourages Medicaid agencies to work with their state 
agencies in considering this opportunity.  
 
Applications for the 2023-2024 school year must be received by FNS by September 30, 2022. 
States will be able to apply for funding to cover the associated project costs. Additional states will 
be able to apply to participate in the demonstrations in future years. 
 
Changes in Medicaid eligibility and processes beginning in 2014 as a result of the Patient Protection and 
Affordable Care Act (ACA; P.L. 111-148), including the shift to using Modified Adjusted Gross Income 
(MAGI) and the presence of new or modernized eligibility systems in state Medicaid agencies, have 
increased the identification of children eligible for both free and reduced price meals.1 
 
 
1Evaluation of Demonstrations of National School Lunch Program and School Breakfast Program Direct Certification of 
Children Receiving Medicaid Benefits: Year 1 Report, January 2015, available at https://www.fns.usda.gov/evaluation- 
demonstrations-national-school-lunch-program-and-school-breakfast-program-direct. Additional evaluations of the current 
demonstrations are available at: https://www.fns.usda.gov/cn/evaluation-direct-certification-medicaid-free-and-reduced- 
price-meals; https://www.fns.usda.gov/nslp/evaluation-direct-certification-medicaid-free-and-reduced-price-meals-dcm-; and 
https://www.fns.usda.gov/cn/usda-dcm-frp-demonstration.    
CMCS Informational Bulletin  Page 2 
 
The new demonstrations will continue to evaluate the potential of direct certification to enroll new 
children, certify currently enrolled children, and impact participation in the free and reduced price school 
lunch and breakfast programs. 
 
For purposes of these demonstrations, the Medicaid program is defined as both Medicaid under  
Title XIX and Medicaid expansion Childrens Health Insurance Programs (CHIP) funded 
under Title XXI of the Act.  However, based on the statutory authority, direct certification will 
not be conducted with separate CHIP programs. To be eligible for direct certification under 
the demonstrations, a child must receive, or live in a household with a child who receives, 
medical assistance under the Medicaid program.  The child must also be a member of a family 
with household income, as measured by the Medicaid program, that does not exceed 130 
percent of the Federal Poverty Level (FPL) for free school meals, and 185 percent of the FPL 
for reduced price school meals.   For children whose eligibility is based on MAGI, income is 
measured before the application of the MAGI standard 5 percentage points of the FPL 
disregard.  For children who may be eligible for Medicaid on a non-MAGI basis, family 
income is measured before the application of any expense-related, block, or other disregards. 
 
State agencies that administer the school meals programs and are selected to participate in the 
demonstration projects must have an agreement in place with the partner state Medicaid agency 
before the data matching process begins.  Under the Health Insurance Portability and Accountability 
Act of 1996 (HIPPA; P.L. 104-191) Privacy Rule at 45 CFR 164.512(k)(6)(i), the state Medicaid 
agency is permitted to share with the school meals program individually identifiable information 
related to Medicaid eligibility and enrollment, provided that the Medicaid agency only discloses the 
minimum amount of information needed to certify or verify the childs school meal eligibility.  See 
also section 1902(a)(7) of the Act; 42 CFR 431.300, et seq.  For example, the Medicaid agency 
could share with the state child nutrition agencies income information used to determine Medicaid 
eligibility necessary to evaluate a child for a free or reduced lunch program, but could not share 
eligibility information for any Medicaid beneficiary not being evaluated for free and reduced school 
meals (e.g., an individual age 65 or over). 
 
State Medicaid agencies are encouraged to work with school meal administrators to streamline 
enrollment in these important nutrition programs.  As part of the application process, Medicaid 
agencies must submit a letter of commitment with the state agencys application package to FNS. 
Medicaid agencies may also assist in the application process by submitting copies of current data 
sharing agreement(s) between the state agency and the Medicaid agency, if they exist, or 
establishing a data sharing agreement if one does not exist. 
 
More information on the Free and Reduced Price Meal Demonstrations is available at 
https://www.fns.usda.gov/cn/direct-certification-medicaid-demonstration-project.  Questions 
regarding the Free and Reduced Price Meal Demonstrations can be directed to Rachel Bishop, 
Senior Advisor, Child Nutrition Division, USDA Food and Nutrition Service, at (703) 305- 
2950 or rachel.bishop@usda.gov.  Questions regarding Medicaid eligibility and data sharing 
protections can be directed to Sarah Lichtman Spector, Director, Division of Medicaid 
Eligibility Policy, Children and Adults Health Program Group, Centers for Medicaid and 
CHIP Services, CMS at (410) 786-3031 or sarah.spector@cms.hhs.gov.