Sponsors
The bill improves Medicaid program integrity and reduces waste through quarterly death-matching while protecting erroneously disenrolled beneficiaries with reenrollment and retroactive coverage, but it risks wrongful disenrollments, raises privacy/data-accuracy concerns, and imposes new state administrative costs.
Medicaid beneficiaries who were erroneously disenrolled will be reenrolled and receive retroactive coverage, restoring access to care and preventing prolonged gaps in treatment.
Taxpayers and state Medicaid programs will see reduced improper payments by stopping future payments for enrollees identified as deceased, lowering waste and saving funds.
State Medicaid agencies will use quarterly automated screening against death records, making identification of deceased enrollees timelier and improving overall program integrity.
Medicaid beneficiaries risk wrongful disenrollment if matches to death records are inaccurate, which can interrupt care until reenrollment is processed.
State Medicaid agencies will incur increased administrative costs to implement and run quarterly matching, potentially diverting resources from services or care delivery.
Relying on the Death Master File raises privacy and data-accuracy concerns for beneficiaries whose records are mistaken or outdated, creating risks to rights and trust in the program.
Based on analysis of 2 sections of legislative text.
Introduced February 20, 2025 by Richard Lynn Scott · Last progress February 20, 2025
Requires States to run quarterly electronic checks of the federal Death Master File (and similar data sources) beginning January 1, 2027, to identify Medicaid enrollees who appear to be deceased. States must treat matches as confirmation of death, disenroll deceased individuals, and stop future Medicaid payments on their behalf, but may not recoup payments for services provided before death and must immediately reenroll and make coverage retroactive if a match is later found to be erroneous. Makes this a mandatory State compliance requirement in the Medicaid statute and allows States to use additional electronic sources so long as they meet the same standards and other Medicaid eligibility rules. No new funding or program authorizations are included in the text provided.