HHS Secretary Delegates Key Multi-Program IT Funding Authority to CMS Administrator

On April 29, 2026, Secretary of Health and Human Services Robert F. Kennedy, Jr. issued a notice in the Federal Register formally delegating substantial authority to the Administrator of the Centers for Medicare & Medicaid Services (CMS). This move centralizes the coordination and approval of federal financial participation for complex, multi-program state information technology projects that underpin crucial safety-net services across the nation.

The Core Delegation: Streamlining IT Funding

The delegation grants the CMS Administrator authorities previously vested in the Secretary under 45 CFR 95.611(a)(4), specifically relating to the Advance Planning Document (APD) process. This regulatory framework governs how states seek Federal Financial Participation (FFP) for expenditures on automated data processing equipment or services. Crucially, the delegated authority pertains to requests that combine Title XIX (Medicaid) and Title XXI (Children's Health Insurance Program, or CHIP) programs with one or more programs under Titles IV-B (Child Welfare Services), IV-D (Child Support Enforcement), and IV-E (Foster Care and Adoption Assistance) of the Social Security Act.

The APD process is vital for states to secure the necessary federal funding for their information technology projects. These projects are not merely administrative conveniences but form the backbone of major safety-net programs that deliver healthcare, financial support, and protective services to millions of Americans. By ensuring coordinated review across various HHS Operating Divisions, the APD process aims to prevent duplication and ensure efficient use of federal resources for integrated state IT solutions.

A Significant Shift from ACF Oversight

This new delegation explicitly rescinds a previous delegation of authority to the Administration for Children and Families (ACF) dated November 8, 2017. That prior delegation had granted ACF the power to coordinate and approve multi-program APDs that included requests for Title XIX and XXI programs. With the latest change, this specific aspect of oversight transitions to CMS.

However, ACF retains a portion of its original authority. The notice clarifies that ACF will continue to coordinate and grant approvals for multi-program requests related only to programs under Titles IV-B, IV-D, and IV-E of the Social Security Act. This means that multi-program APDs involving only child welfare and family support services will still be reviewed by ACF, while those that integrate Medicaid or CHIP with these programs will now fall under CMS's purview. This bifurcation of authority underscores a strategic decision to place health-related IT funding requests primarily within the agency responsible for those health programs.

Operational and Policy Implications

The immediate effectiveness of this delegation means that states pursuing FFP for complex, integrated IT systems involving both health and child welfare components will now interact primarily with CMS for their APD coordination and approval. This centralization under CMS could lead to more streamlined processes for states, particularly those seeking to integrate health and human services data systems. It may also reflect a departmental strategy to enhance consistency in the review of large-scale IT investments that impact federal healthcare spending.

Administratively, the delegated authority may be redelegated further within CMS, but not below the level of the Director, Division of Performance and Organizational Programs, Office of Human Capital. This restriction aims to ensure that high-level administrative expertise is maintained in the review process. Secretary Kennedy, Jr. explicitly affirmed and ratified any actions taken by the CMS Administrator or their subordinates involving these authorities prior to the delegation's effective date, providing legal continuity. The Secretary also retains the fundamental authority to promulgate regulations, ensuring overarching policy control remains at the highest level of HHS.

This shift represents a significant administrative reorganization, potentially influencing how states conceive, develop, and implement their critical IT infrastructure for safety-net programs. The intent appears to be a more unified approach to federal oversight for IT investments that touch upon the vast federal healthcare programs managed by CMS.