LIVE Beneficiaries Act
- Bill Number
- H.R. 1403
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-02-18: Referred to the House Committee on Energy and Commerce.
- Last Updated
- 2026-06-11T23:26:38Z
AI-Generated Summary
Purpose of the Legislation
The LIVE Beneficiaries Act aims to improve the accuracy of Medicaid enrollment by requiring states to regularly check if enrolled individuals are deceased, preventing payments for ineligible beneficiaries and reducing improper spending in the Medicaid program (a federal-state health insurance program for low-income people).
Key Provisions
- Quarterly Verification Requirement: Starting January 1, 2027, states (the 50 states and District of Columbia) must review the Death Master File—a federal database of reported deaths—at least every three months to identify deceased individuals enrolled in Medicaid under state plans or waivers.
- Disenrollment Process: If a match confirms death, states must:
- Treat the information as verified fact under federal regulations.
- Remove the individual from coverage.
- Stop future payments for their care, but allow payments for services provided before death.
- Error Correction: If a state finds the death was misreported (e.g., identity mix-up), it must immediately reinstate coverage retroactive to the disenrollment date.
- Flexibility for States: States can use additional electronic data sources to identify deceased enrollees, as long as they meet the Death Master File requirement and other Medicaid rules.
Significant Changes to Existing Law
- Amends Section 1902 of the Social Security Act (which outlines state Medicaid plan requirements) by adding a new paragraph (88) mandating compliance with these verification rules.
- Introduces a new subsection (uu) detailing the quarterly screening, disenrollment, and reinstatement processes.
- Builds on existing federal regulations (e.g., 42 CFR 431.213) for handling death information but makes quarterly Death Master File checks mandatory, whereas prior law encouraged but did not require such routine verification.
Potential Impacts
- On Government Agencies: Increases administrative workload for state Medicaid agencies to conduct screenings and handle disenrollments/reinstatements; may reduce federal and state spending by preventing payments to deceased individuals (estimated improper payments in Medicaid have been a concern). The Centers for Medicare & Medicaid Services (CMS) may need to provide guidance or oversight.
- On Citizens: Protects living Medicaid beneficiaries by ensuring program funds are not wasted, but could cause temporary disruptions if errors occur (though reinstatement is required). Taxpayers benefit from potential cost savings.
- On International Relations: No direct impact, as this is a domestic health policy measure.
Main Stakeholders Affected
- State Governments and Medicaid Agencies: Bear the primary responsibility for implementation and compliance.
- Medicaid Enrollees: Particularly vulnerable populations (e.g., low-income families, elderly, disabled) who rely on the program; they could face coverage gaps from errors but gain from program integrity.
- Federal Government (e.g., CMS and Treasury): Oversees enforcement and maintains the Death Master File; benefits from reduced improper payments.
- Taxpayers and Healthcare Providers: Indirectly affected through potential savings and more efficient use of public funds.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens compliance with existing federal regulations on eligibility verification without altering core Medicaid eligibility rules; includes safeguards against errors to avoid due process issues for beneficiaries.
- Constitutional: No apparent challenges, as it involves state administration of a federal program under Congress's spending power.
- Political: Could spark debate over administrative burdens on states versus fiscal responsibility; supporters may highlight anti-fraud benefits, while critics might argue it diverts resources from care delivery. Applies only to states and DC, excluding territories, which may raise equity questions.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Bilirakis, Gus M. [R-FL-12]
Cosponsors (3)
Rep. Craig, Angie [D-MN-2], Rep. Calvert, Ken [R-CA-41], Rep. Davids, Sharice [D-KS-3]
Recent Actions
- 2025-02-18: Referred to the House Committee on Energy and Commerce.
- 2025-02-18: Introduced in House
- 2025-02-18: Introduced in House
Bill Versions
- Leveraging Integrity and Verification of Eligibility for Beneficiaries Act — issued 2025-02-18 — PDF (4 pages)