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CMS announced on Tuesday that it was initiating a new system for identifying illegal immigrants in Medicaid and the Children’s Health Insurance Program (CHIP). Under the new initiative, each state will receive a monthly report from CMS on enrollment in Medicaid and CHIP. States will then be responsible for reviewing all Medicaid or CHIP enrollees whose citizenship or immigration status cannot be verified through federal government databases.

CMS has been working on the new system for months and will begin sending monthly reports to each state this week. Once it has received its report from CMS, each state will then have the responsibility of reviewing the immigration status of enrollees flagged in CMS’s report. States will then have to notify CMS of the outcome of their reviews.

The agency sent the first of these reports on Tuesday. The agency will send each state its own report each month, which it will be required to review. States will then be required to update CMS on the outcome of these reviews, to confirm that an enrollee is legally eligible to remain enrolled.

CMS officials stressed that states could not terminate coverage to enrollees whose citizenship or immigration status could not be verified until after they had completed a review of the information in the CMS report. “We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,” Health and Human Services Secretary Robert F. Kennedy Jr. said in a statement.

CMS Administrator Dr. Mehmet Oz had similar things to say. “This action will strengthen our efforts to ensure that Medicaid and CHIP continue to operate as effective safety-net health programs for those who are eligible for coverage and have no other source of health care,” Oz said. “We cannot tolerate the abuse of these programs, and we are committed to ensuring they are only being used by those who are eligible.”

Tuesday’s announcement is part of a larger effort by the Trump administration to restrict illegal immigrants from accessing federal public benefits. During his second term, Trump has issued several executive orders that have furthered this effort. One of the first orders he signed this term, in February, was a memo directing agencies to review all federal benefit programs and report back to the White House on what actions were needed to ensure non-citizens were not inappropriately receiving them in violation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

CMS also acted to further this goal back in February by adding a number of government programs to the official list of public benefits. The list of government programs, which were now considered public benefits, was extended from 31 to 44 programs. The long list means more of these programs would be subject to verification and status checks.

On one hand, the Trump administration has also been forced to halt certain efforts on immigration due to legal challenges and court orders. Last month, a federal judge issued an order to the Health and Human Services to stop passing enrollee information to immigration authorities. The Trump administration began passing enrollment information to Immigration and Customs Enforcement (ICE) in order to assist with deportations, but the judge ruled that the department did not have the authority to do so.

On the other hand, states are also now subject to additional requirements tied to the spending package passed by Congress last month. The bill, which included major Republican changes to spending in several federal agencies, requires states to conduct eligibility verification on Medicaid enrollees at least twice per year. The current requirement is one eligibility check every two years.

This comes as a coalition of over two dozen state attorneys general has already filed a lawsuit against this provision. Led by New York Attorney General Letitia James, the Democratic-led coalition says that having to verify immigration status as a condition for receiving federally funded benefits is a major threat to access to vital government services.

“This is an explicit and intentional attempt to scare New Yorkers and people across the country into forgoing health care and food and other services that they need,” James said last month. “They’re threatening families in every part of this state. The last thing they should be doing is using the bureaucracy to come after us like this.”