S.678 - Leveraging Integrity and Verification of Eligibility for Beneficiaries Act; LIVE Beneficiaries Act (119th Congress)
Summary
The LIVE Beneficiaries Act (S.678) aims to amend Title XIX of the Social Security Act, mandating states to verify the eligibility of individuals enrolled for medical assistance on a quarterly basis. This verification primarily involves cross-referencing enrollee data with the Death Master File to identify deceased individuals. The bill seeks to prevent improper payments and ensure the integrity of the Medicaid program.
The Act requires states to disenroll individuals identified as deceased and discontinue payments made on their behalf, while also providing a mechanism for reinstatement in case of misidentification. The Act is set to begin on January 1, 2027.
Overall, the bill focuses on reducing fraud and errors in Medicaid eligibility, potentially leading to cost savings for the government.
Expected Effects
The primary effect of this bill will be increased scrutiny of Medicaid enrollee data, leading to more frequent disenrollments of deceased individuals. This will likely result in reduced improper payments and potential cost savings for state and federal governments.
States will need to implement systems to comply with the quarterly verification requirement, which may involve administrative costs. The bill also includes provisions for reinstating coverage if an individual is erroneously disenrolled, adding another layer of administrative complexity.
Beneficiaries may experience temporary disruptions in coverage if errors occur, highlighting the importance of accurate data and efficient reinstatement processes.
Potential Benefits
- Reduced fraudulent or improper payments made on behalf of deceased individuals, leading to potential cost savings for taxpayers.
- Improved integrity and accountability within the Medicaid program.
- More accurate enrollment data, allowing for better resource allocation and program management.
- A mechanism for reinstating coverage for individuals erroneously disenrolled, mitigating potential harm.
- Encourages states to utilize electronic data sources for timely identification of deceased beneficiaries.
Most Benefited Areas:
Potential Disadvantages
- Potential for erroneous disenrollments based on inaccurate data from the Death Master File, leading to temporary loss of coverage for eligible individuals.
- Increased administrative burden and costs for states to implement and maintain the quarterly verification system.
- Possible delays in reinstating coverage for individuals who were wrongly disenrolled, causing disruptions in healthcare access.
- Concerns about data privacy and security related to the use of the Death Master File.
- The bill may disproportionately affect vulnerable populations who may have difficulty navigating the reinstatement process.
Most Disadvantaged Areas:
Constitutional Alignment
The bill appears to align with the Constitution's general welfare clause (Article I, Section 8), as it aims to ensure the efficient and responsible use of taxpayer funds within the Medicaid program. By reducing improper payments, the bill seeks to promote the general welfare by allocating resources more effectively.
However, the bill's impact on individual rights and due process should be considered. While the bill includes a mechanism for reinstatement in case of erroneous disenrollment, it is crucial to ensure that this process is fair and accessible to all beneficiaries. The Fifth and Fourteenth Amendments guarantee due process, which includes the right to a fair hearing before being deprived of government benefits.
Overall, the bill's constitutionality depends on its implementation and whether it adequately protects the rights of Medicaid beneficiaries while achieving its goal of reducing fraud and errors.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).