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The 2027 work-requirement notice kit

A notice checklist, an annotated before and after, an English/Spanish phrase bank, the language-access checklist and a 6-month renewal planner. All of it is on this page.

Download PDF (12 pages)

Last reviewed 2026-10-09

A review aid, not an approved legal template.

Why these notices matter now

Under Public Law 119-21, states apply community-engagement requirements to many adults in the Medicaid expansion group from 2027-01-01, and renew their eligibility every 6 months. Some states may get more time. CMS issued the interim final rule on 2026-06-01, and the required outreach to members is already under way. Each notice now has to say what a member must do, by when, and how to get help, in every language the state serves.

2026-06-01
CMS issues the interim final rule
2027-01-01
States apply community-engagement requirements to many expansion adults; some may get more time
Then
Eligibility renewed every 6 months

An annotated notice, before and after

One paragraph from a synthetic notice. The numbers in the notes match the changes in the plain version. Brackets mark what your state fills in.

Synthetic example: Community-engagement notice. Not a member or patient document.

Before

Pursuant to applicable federal and state requirements, individuals determined to be within the applicable population are required to demonstrate compliance with community engagement requirements as a condition of continued eligibility for medical assistance. Failure to submit verification of qualifying activities or of an applicable exemption within the prescribed timeframe will result in termination of coverage. Individuals who disagree with this determination may request a fair hearing in accordance with program rules.

After

You need to tell us about your work or other activities to keep your [program name] coverage.

What to do: Report at least 80 hours a month of work, school, job training or volunteering. Or tell us why you can't.

By when: [date]. If we don't hear from you, your coverage may end on [date].

You may not have to do this. Some people don't, for example if you are pregnant or have a serious health condition. See the list on page 2, or call us and we will check.

Help: Call [phone], free, TTY 711. You can get this letter in other languages and formats.

If you disagree, you can ask for a fair hearing. Ask by [date].

Words per sentence, before and after

Before

71 words in 3 sentences · longest 33 words

After

119 words in 12 sentences · longest 17 words

Each bar is one sentence or line of the synthetic example above, drawn to the same scale. The plain version says the same thing in shorter pieces, each with one job.

What changed and why

The action comes first, in the member's words, instead of "demonstrate compliance".
One number and one date. The consequence follows the date, so it reads as a deadline, not a threat.
Exemptions appear before the member gives up, with a way to check.
The help line says it is free and gives the TTY number.
Appeal rights keep their own date.
The official program name stays exactly as the state writes it.

English/Spanish phrase bank

Plain phrases for the parts every notice needs. The Spanish uses usted. A qualified reviewer checks the variant your members read (US, Puerto Rico or Mexico) before you use it.

Plain-language phrases in English and Spanish
English	Spanish	Use it for
You need to tell us about your work or other activities.	Necesitamos que nos informe sobre su trabajo u otras actividades.	The requirement
You may not have to do this.	Es posible que usted no tenga que hacer esto.	Exemptions
Report your hours by [date].	Informe sus horas a más tardar el [fecha].	The deadline
Your coverage may end on [date].	Su cobertura podría terminar el [fecha].	The consequence
Call us for free at [phone].	Llámenos gratis al [teléfono].	Where to get help
You can ask for a fair hearing.	Usted puede pedir una audiencia imparcial.	Appeal rights
Renew your coverage every 6 months.	Renueve su cobertura cada 6 meses.	Renewals

Language rules sheet

Decide these once, write them down, and apply them to every notice. These are the same rules HealthLiteracyCopilot locks at the organization level.

Pick the Spanish variant for each audience (US, Puerto Rico or Mexico) and use it throughout a document.
Choose formal usted or informal tú once, and keep it in every document.
Keep official program names exactly as the state writes them, in every language.
Keep dates, dollar amounts, phone numbers and member ID placeholders exactly as they are in English.

When a person must translate

A segment that would lose a date, a dollar amount, a member ID placeholder or a "not" goes to a human translator, never a guess. That is how HealthLiteracyCopilot's translation hand-off works.

A date or a deadline
A dollar amount or a number of hours
A member ID or another placeholder
A negative ("not", "don't", "no longer") that changes what the member must do

Each translated segment

Would it lose one of these?

A date or a deadline
A dollar amount or a number of hours
A member ID or another placeholder
A negative ("not", "don't", "no longer") that changes what the member must do

YesA human translator

6-month renewal planner

With renewals every 6 months, each renewal notice reaches a member twice a year. List each notice, its two mailing months and its languages, and plan its review before each mailing. The first row is an example.

The example row

The renewal notice goes out in January and again in July, 6 months apart. Each mailing is a separate chance to review it first.

Renewal planner: one row per notice
Notice	First mailing	Second mailing	Languages	Owner	Reviewed before mailing
Renewal notice (example)	January	July	English, Spanish	Eligibility communications	Yes

Type in the table, then download it for Excel or Google Sheets. Your entries stay in this tab: nothing is sent or saved, so download before you leave the page.

The notice checklist

Check every community-engagement and renewal notice for these seven parts before it goes out.

Document you're checking (optional)

0 of 7 checked

Every notice says

1. What the requirement is, in one plain sentence
Source: CMS fact sheet: Medicaid community engagement requirement interim final rule
2. Who it applies to, so a member can tell whether it applies to them
3. Who does not have to do it, and how to ask for an exemption
4. How to report: by phone, online, by mail or in person
5. The deadline, as a date, and what happens after it
6. Where to get help, free, including TTY and language assistance
Source: 45 CFR 92.11, notice of availability of language assistance
7. Appeal rights, with their own date
Source: 42 CFR 438.10, Medicaid managed care information requirements

Notes for the reviewer (optional)

Your answers stay in this tab: nothing is sent or saved. Download or print before you leave the page.

Sources

After the kit

Get a free assessment of one Medicaid notice

Compose an email

Send a blank template, not a copy with a patient's or member's details.

Email me this resource

This resource is already open on this page. This sends you a link to it.

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Questions

Is this an approved legal template?

No. It is a review aid. Your state or plan legal team approves the final wording of every notice.

Is the Spanish ready to use?

The phrases are a starting point. A qualified reviewer checks them against the Spanish variant your members read before you use them.