Sponsors (4)
The bill strengthens Medicaid program integrity and reduces improper payments by standardizing quarterly Death Master File checks, but it raises privacy risks, the potential for harmful false matches that can interrupt coverage, and added administrative costs for states.
State Medicaid programs will identify deceased enrollees through regular DMF matching and stop inappropriate post‑death payments, reducing improper spending for taxpayers and state budgets.
Medicaid beneficiaries who were erroneously disenrolled will be promptly reenrolled with retroactive coverage, protecting people from gaps in care and unexpected medical bills.
States and D.C. will use a standardized, quarterly Death Master File verification process, creating clearer and more consistent procedures that improve program integrity and administrative clarity across jurisdictions.
Medicaid beneficiaries' personal death‑related data will be regularly matched and used administratively, raising privacy and data‑security concerns about routine use and storage of sensitive information.
Medicaid beneficiaries risk wrongful disenrollment if the Death Master File contains errors or false matches, which could cause temporary loss of coverage and interrupted care despite reenrollment protections.
State governments will incur administrative costs to implement quarterly DMF screening, update systems, and process disenrollments/reenrollments, potentially diverting resources from other services.
Based on analysis of 2 sections of legislative text.
Requires states and D.C. to screen the Social Security Death Master File quarterly to disenroll deceased Medicaid enrollees and stop post-death payments, effective Jan 1, 2027.
Official title: To amend title XIX of the Social Security Act to require States to verify certain eligibility criteria for individuals enrolled for medical assistance quarterly, and for other purposes.
Introduced February 18, 2025 by Gus Bilirakis · Last progress February 18, 2025
Requires states and D.C. to screen the Social Security Death Master File (and optionally other electronic death-data sources) at least quarterly to identify Medicaid enrollees who have died, treat matches as conclusive for termination purposes, disenroll deceased individuals, and stop post-death payments starting January 1, 2027. If a match is erroneous, states must promptly reenroll the person and provide retroactive coverage for services furnished before re-enrollment. Also adds a new mandatory state-plan term to Medicaid law that applies to the 50 states and D.C., specifies treatment of matched records as conclusive under federal regulation, allows use of additional electronic data sources alongside the Death Master File, and limits post-death payment exceptions to items/services furnished before death.