Health Benefits Eligibility and Enrollment Rules (HBEE)

The Health Benefits Eligibility and Enrollment (HBEE) rules provide the eligibility standards for Medicaid and other health care programs.

HBEE Adopted Rules (by Part)
HBEE Combined Rules Document (Parts 1 - 8)
Temporary changes that impact HBEE rules and corresponding public notice in the Global Commitment Register (GCR)
Proposed HBEE Rules
Repealed (old) Medicaid Rules

HBEE Adopted Rules (by Part)

HBEE Part 1 - General Provisions and Definitions (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 2 - Eligibility Standards (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 3 - Nonfinancial Eligibility Requirements (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services and Supports - Eligibility and Post-Eligibility (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 5 - Financial Methodologies (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 6 - Small Employer Health-Benefits Program Rules

HBEE Part 7 - Eligibility-and-Enrollment Procedures (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Part 8 - State Fair Hearings and Expedited Eligibility Appeals (*GCR 23-082 through 23-088 HBEE adopted rules (Parts 1, 2, 3, 4, 5, 7, 8) were filed with the Secretary of State on 12/8/2023 and are effective 1/1/2024)

HBEE Rules Parts 1 - 8 Combined (1/1/2024)

Temporary Changes that Impact HBEE Rules

GCR 22-100: Temporary Adjustments to Premium Assistance under the American Rescue Plan Act
- Effective January 1, 2021 - December 31, 2025
- Affects the following parts of HBEE:
  - Part 2, Section 12.03(a) Applicable tax filer
  - Part 7, Section 60.07(b) Applicable percentage table for advanced premium tax credits

Proposed HBEE Rules

The following final proposed rules have been filed with the Legislative Committee on Administrative Rules. See GCR 24-075 to 24-077 for more information.