On October 29, 2026, a federal judge ruled (PDF) that the Centers for Medicare and Medicaid Services (CMS) did not have the authority to narrow the definition of “medical frailty” by requiring documentation that a health condition limits the ability to work or volunteer.
As a result, to qualify for an exemption to Medicaid work requirements, individuals will only need to show they have a condition that is listed in one of the five medical frailty categories, rather than the burdensome, multi-step process outlined in the overturned rule. Cancer is one of the categories, so breast cancer patients are automatically exempt from work requirements.
NBCC previously expressed deep concern over the narrowing of the “medical frailty” definition in the CMS rule and will continue to monitor any additional steps that could jeopardize the ability of breast cancer patients to gain access to Medicaid.
