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The Centers for Medicare and Medicaid Services (CMS) announced Tuesday a major expansion of its enforcement efforts to verify the eligibility of Medicaid and CHIP enrollees. CMS said Tuesday that under the new system, all 50 states will begin to receive monthly reports of enrollees whose citizenship and immigration status have not been verified through a federal data-match program.

CMS began the effort as part of an executive order from President Donald Trump in his first term. But since Trump was sworn in for his second term, the agency has expanded the scope of the system in new ways, with the latest change going into effect next week. According to CMS officials, federal officials have asked states for additional information to verify citizenship and immigration status for many years.

CMS will ask states to verify the citizenship or immigration status of all enrollees who cannot be matched with federal databases, including information maintained by the Social Security Administration, and the U.S. Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program, among other databases.

States will have an opportunity to verify these individuals before taking any action.

“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 also said in a statement that the effort was critical to ensuring the integrity of safety-net health programs, “Every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP. This action underscores our unwavering commitment to program integrity, safeguarding taxpayer dollars, and ensuring benefits are strictly reserved for those eligible under the law.”

CMS has been moving ahead with verification measures as the Trump administration and Republican leaders in Washington have also been eyeing reforms to Medicaid and the Children’s Health Insurance Program. CMS said in July that it had received more than 800,000 reports from states verifying individuals’ immigration or citizenship status. The latest system has reportedly been in development for the better part of a year.

CMS said it first issued these reports on Tuesday. The agency said throughout the course of each month, it will send individual reports to each state and require them to verify any individuals flagged by the system. The agency said it would then require states to report their findings back to CMS.

CMS’s move comes just a few weeks after the Trump administration, at the behest of Republicans on Capitol Hill, added a series of new rules and requirements to Medicaid and CHIP. The latest Medicaid package requires state Medicaid agencies to verify the immigration status of every enrollee at least twice per year. The prior standard was once every three years.

The CMS verification push has also faced immediate legal pushback in the courts. Just last month, a federal judge ordered the Department of Health and Human Services to stop handing over enrollee data to immigration authorities. HHS had been sharing Medicaid and CHIP enrollment information with Immigration and Customs Enforcement (ICE) to aid in deportation efforts.

States will also have new statutory requirements thanks to a bipartisan package of spending legislation last month. The package required states to conduct eligibility checks on Medicaid enrollees at least twice per year.

States have criticized the move, with a coalition of more than 20 Democratic attorneys general suing the administration over the rules. The group, led by New York Attorney General Letitia James, has asked the court to block the rules from going into effect until the case can be fully heard in court.

“We’ve long known the Trump administration is set on restricting access to critical health care services by threatening immigrants and mixed-status families who rely on Medicaid for their care,” James said. “Now, we know the Administration plans to illegally implement its vision by mandating that Medicaid agencies collect citizenship information from every enrollee nationwide.”

CMS says the expansion of its verification system will help root out ineligible enrollees. The agency has said previously that it had encountered “significant numbers of illegally residing aliens” in the Medicaid and CHIP programs.

CMS Deputy Administrator Joan A. Alker has said in the past that CMS is concerned about the increasing number of individuals unlawfully present in the U.S. enrolling in Medicaid and CHIP, even though “states are already required to confirm eligibility,” she told The Daily Caller News Foundation. “We remain committed to working with states and Medicaid beneficiaries to make the process of verifying citizenship and eligibility as easy as possible.”