Who is affected and how:

• Medicaid beneficiaries: Directly affected if records indicate they are deceased. Most will be unaffected, but a small number could be wrongly disenrolled if data matches are incorrect; the law requires immediate reenrollment in those cases. Disenrollment stops most Medicaid payments tied to that person.

• State governments / State Medicaid agencies: Primary actors required to run quarterly checks, process matches, carry out disenrollments, stop payments, and implement rapid reenrollment procedures. Agencies will face administrative and IT work to connect to the Death Master File or alternative sources and to manage appeals and corrections.

• Health care providers and payees: Payments tied to a disenrolled person will be stopped; providers may see claims denied or payments halted if beneficiaries are removed before errors are fixed.

• Program integrity and budgets: The requirement is likely to reduce improper payments for deceased beneficiaries, producing potential savings. However, states may incur implementation costs (systems, staff, data agreements) and face risks of disruption if matches are inaccurate.

• Privacy and data-quality concerns: Use of death-record matches raises the importance of accurate data matching, secure data handling, and clear procedures to minimize wrongful disenrollment and to restore coverage promptly when mistakes occur.

Overall, the rule places routine data-matching duties on states to close out benefits for deceased enrollees while mandating quick correction for errors; the administrative burden falls primarily on state Medicaid systems, and beneficiaries face potential short-term coverage loss if mistakes occur.