The Trump administration has elevated Medicaid, Medicare, and Affordable Care Act (ACA) program integrity as a central domestic policy priority. The Centers for Medicare and Medicaid Services (CMS) advanced this initiative by issuing the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) Request for Information (RFI) on February 27, 2026.

The RFI seeks public input on a wide range of potential regulatory actions, including Medicaid financing mechanisms (Intergovernmental Transfers or IGTs, supplemental payments, and state-directed payments), provider enrollment and screening, eligibility verification, and expanded Federal oversight authority. Together, the statutory framework established by H.R. 1 and the breadth of stakeholder responses underscore the significance of this effort and its potential implications for future CMS policy.

CMS received 768 public comments, approximately 340 of which are currently posted to CMS’s website. CMS has not indicated whether additional submissions will be released.

Sellers Dorsey summarized public comment submissions. Our analysis reflects 196 submissions relevant to the Medicare, Medicaid, and the ACA programs reviewed as of April 24, 2026.