Medicaid Rolls to Get Quarterly Check-Ups Against Death Records Starting 2027: The LIVE Beneficiaries Act

The LIVE Beneficiaries Act, officially titled Leveraging Integrity and Verification of Eligibility for Beneficiaries Act, mandates that states start verifying Medicaid eligibility more frequently. Instead of sporadic checks, states will now have to cross-reference their Medicaid rolls with the Death Master File (DMF) every three months, beginning January 1, 2027 (SEC. 2).

Death and Medicaid Taxes

The core of the bill is straightforward: find dead people on Medicaid, and remove them. States are required to check the Death Master File quarterly and disenroll anyone listed as deceased. Payments for these individuals' medical assistance will also stop. Think of it like a regular subscription service – if you're not around to use it, the service ends. If someone is mistakenly flagged as deceased, the bill requires their coverage to be reinstated immediately, retroactive to the date they were cut off (SEC. 2).

Beyond the Master File

While the Death Master File is the primary tool, states aren't limited to just that. The bill allows them to use other electronic data sources to identify potentially deceased beneficiaries, provided they still comply with the quarterly DMF checks (SEC. 2). This gives states some flexibility in how they maintain accurate records.

Real-World Rollout

Imagine a small business owner who relies on Medicaid. If, due to a clerical error, their name mistakenly appears on the Death Master File, they could temporarily lose coverage. The bill addresses this: immediate reinstatement with backdated coverage. However, even a brief gap could be disruptive, especially for those with ongoing medical needs. For instance, if someone's monthly prescriptions are suddenly unavailable, that's a real problem, even if it's fixed relatively quickly.

While the goal is accuracy and efficiency, the practical challenge lies in the execution. Data matching isn't foolproof. Errors in the Death Master File or in state records could lead to wrongful terminations. The bill acknowledges this by mandating reinstatement, but the process of proving you're not dead might involve some bureaucratic hurdles, which can be a headache, even if the situation is resolved.

This new requirement is part of a broader push for better management of government programs. It builds on existing Social Security Act provisions (Title XIX) by adding a more rigorous verification process. The long-term impact? Ideally, fewer improper payments, which could translate to cost savings for states. But the success hinges on accurate data and efficient processes to handle errors, ensuring that eligible individuals aren't caught in the crossfire.