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The Centers for Medicare and Medicaid Services (CMS) on Tuesday said that it is working to expand federal enforcement of public insurance programs in order to remove illegal immigrants from Medicaid and the Children’s Health Insurance Program (CHIP). CMS on Tuesday sent a new directive to state Medicaid agencies that will require officials to use federal databases to verify that enrollees’ immigration and citizenship status match eligibility requirements for enrollment.

The Trump administration is the latest in the federal government’s effort to crack down on public benefits for illegal immigrants. According to CMS officials who first reported the directive, the CMS will send monthly reports to state Medicaid officials to verify that all enrollees meet immigration and citizenship requirements. The report will send a list of individuals whose citizenship and immigration status are not available through federal verification databases, such as the Social Security Administration and the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

The directive comes from CMS Administrator Dr. Mehmet Oz, who wrote that federal officials in Medicaid “must work together to improve verification practices to the greatest extent possible and in compliance with applicable federal and state law.”

CMS released the first of its regular monthly verification reports on Tuesday and will continue to do so each month. States must review the cases provided by CMS officials and report back to the federal government whether enrollees remain eligible or if they have since removed ineligible immigrants.

CMS officials have made it clear that the expansion of the public insurance eligibility checks comes as part of an effort to ensure only eligible U.S. citizens and residents are receiving taxpayer-funded benefits. “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.

This new step is part of a larger effort by the Trump administration to clamp down on access to federal benefits for illegal immigrants. Republicans have long advocated for tougher restrictions on illegal immigrants’ access to benefits in a wide range of safety net programs. During his first term, Trump signed several executive orders tightening eligibility criteria for public benefits. On his first day back in office, Trump signed an executive order directing federal agencies to look at the scope of the problem and develop additional policies to ensure that illegal immigrants are no longer eligible for certain public benefits.

Trump also instructed the federal government to review programs to tighten eligibility. Under the order, every federal agency has been working to address how it can better identify illegal immigrants and non-citizens who have been erroneously receiving certain benefits from the federal government.

In March, the Trump administration also issued a new rule that expanded the definition of what benefits qualify as “public” and are subject to additional eligibility screening. The updated guidance included a new list of government benefits and public services. The list grew from 31 programs to 44, which means that more people will be affected by the CMS directive to states in the future.

A federal judge has also weighed in on this issue. Last month, a federal judge in New York blocked the Trump administration from sharing Medicaid enrollment data with immigration enforcement agencies without a warrant or some other due process. The judge ruled that a CMS policy allowing information sharing violated a long-standing law that requires the agency to obtain a court order to release personal data from Medicaid recipients.

States will also face additional reporting requirements on Medicaid as part of a major spending package passed last month. The bill, which passed the Senate last month, requires states to verify enrollment eligibility for Medicaid at least twice a year. The current requirement is once every three years. The Trump administration is already facing legal action from over two dozen Democratic states over the new rules.

New York Attorney General Letitia James said that the new verification requirement is a “baseless attack” on vital Medicaid programs in a state that has an estimated 2.4 million Medicaid enrollees.

“This is a baseless attack on some of our country’s most effective and inclusive public programs, and we will not let it stand,” James said last month. “For decades, states like New York have built health, education, and family support systems that serve anyone in need. These programs work because they are open, accessible, and grounded in compassion. Now, the federal government is pulling that foundation out from under us overnight, jeopardizing cancer screenings, early childhood education, primary care, and so much more.”