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On Tuesday, the Centers for Medicare and Medicaid Services (CMS) said it would take new steps to review immigrants’ eligibility for the federal health insurance programs and strip the benefits from illegal immigrants.

CMS officials first announced the initiative last week. It is part of a broader administration effort to ensure that non-citizens are not receiving taxpayer-funded benefits.

Starting next month, CMS will distribute monthly enrollment files to all states that detail Medicaid or CHIP enrollees for whom citizenship or immigration status cannot be verified using federal databases. The databases include those used by the Social Security Administration as well as the Systematic Alien Verification for Entitlements (SAVE) program, run by the Department of Homeland Security.

The first such report was sent out on Tuesday. Each state will get its own monthly report going forward and will have to review it, CMS said. If the state determines through its own enrollment process that the individual is indeed eligible, the state will have to confirm that back to CMS.

“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.

The CMS move is just the latest to tighten the linkage between eligibility for public benefits and immigration status in an effort to bolster the integrity of public programs and weed out those who aren’t eligible.

Trump Orders Agencies to Crack Down on Illegal Immigrants’ Access to Federal Benefits

The executive order, issued in February, called on agencies to review all federal benefit programs and “take all appropriate action” to ensure that non-citizens are not receiving them in violation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, a welfare reform law championed by Republicans.

In March, the HHS expanded the list of federal programs considered to be public benefits. As a result, the number of programs subject to verification and other scrutiny increased from 31 to 44.

Federal Judge Blocks HHS From Sharing Beneficiaries’ Information With ICE

The latest CMS reporting requirements are part of a series of efforts to add verification and scrutiny to safety-net health care programs like Medicaid and CHIP.

Just last month, a federal judge in New York ordered the Department of Health and Human Services to stop sharing beneficiary information with ICE. The Trump administration began sharing the information with ICE in an effort to support deportation, but the court ruled that doing so exceeded HHS’s authority.

CMS action also comes as state officials are now required to conduct eligibility reviews on Medicaid beneficiaries at least twice per year. The Department of Health and Human Services is responsible for the enforcement of the new requirement, which was included in a major Republican spending package passed last month.

The law had previously required states to conduct eligibility reviews just once per year. Supporters of the new requirement argue that such measures are critical to prevent fraud and abuse. The changes also come amid legal challenges by a coalition of more than 20 Democratic attorneys general. Led by New York Attorney General Letitia James, the group of state officials has sued the administration over a separate requirement that the attorneys general verify the immigration status of people who access certain federally funded programs.

James blasted the Trump administration’s new requirements, which, she said, required officials to “play immigration officer.”

“At a time when many states are struggling to meet the public health, economic, and social needs of our residents, the federal government’s actions will have a devastating impact,” James said last month. “These regulations will create enormous red tape for families and increase uncompensated care costs for providers across the board.”

CMS sent out its first file detailing Medicaid and CHIP enrollees with indeterminable immigration and citizenship status on Tuesday. The fight over immigrants’ access to public benefits is likely to continue in court. The parties, and the Medicaid and CHIP beneficiaries they represent, may also find a federal court, unless and until Congress acts to rewrite or reform the laws.