Summary

Requires states and the District of Columbia to run automated checks of the federal Death Master File every quarter starting January 1, 2027, to find Medicaid enrollees who appear to be deceased. When a match is found, states must treat the match as conclusive proof of death, disenroll the individual, and stop future Medicaid payments (but not payments for services provided before death); if the match is later found to be a misidentification, the state must immediately reenroll the person and make coverage retroactive.

Key Points

• States and DC must run automated quarterly checks of the federal Death Master File for Medicaid enrollees starting Jan 1, 2027.
• A Death Master File match is treated as conclusive proof of death for federal Medicaid verification rules.
• States must disenroll matched individuals and stop future Medicaid payments, but not payments for services provided before death.
• If a match is later found to be a misidentification, the state must immediately reenroll the person and make coverage retroactive.
• Requirement applies only to the 50 States and the District of Columbia, not U.S. territories.
• States may use other electronic data sources if they comply with Medicaid rules and the new verification standard.
• The change adds a new State plan condition of eligibility but does not itself appropriate funds.
• Implementation will require system integration, new administrative procedures, and safeguards against wrongful disenrollment.

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