Medicaid Verification Program

The Challenge

Implementing the new Medicaid work requirements in compliance with the One Big Beautiful Bill Act will require extensive changes and administrative tasks for all states, health plans, and subsequently, our most vulnerable populations. Successful implementation strategies will require cross-sector collaboration, clear and consistent messaging to Medicaid recipients via multiple communication methods, and a scalable approach to decrease the administrative burden of compliance.

Timely member engagement and document submission decreases attrition, fragmented care delivery, and uncompensated care, and improve quality scores.

The Solution

The Medicaid Verification Program is a scalable, automated text-based solution that helps states, health plans, and members meet the One Big Beautiful Bill Act requirements. The Act mandates written communication plus at least one additional outreach method; GoMo Health extends this through text and email to keep members informed and engaged. After eligibility determinations, the program guides compliance, simplifies the process, and builds trust between members, plans, and states, delivering:

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State-by-State Flexibility
State-by-State Flexibility

Adapts to differing authorization timelines, exemption rules, and submission processes defined by each state

Frictionless Member Experience
Frictionless Member Experience

No app or login required; members receive all communications via text messages and/or emails.

Automated Education and Reminders
Automated Education and Reminders

Increase member adherence to deadlines with automated reminders and education about new processes.

Retention Support
Retention Support

Seamlessly transitions disqualified members to ACA Marketplace plans.

Key Benefits for Health Plans

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Automates outreach and compliance support, lowering administrative workload and reducing costly member churn and uncompensated care.
Protects Medicaid enrollment by proactively guiding members through compliance requirements.
Automates high-volume outreach, freeing staff to focus on complex cases.
BehavioralRx® science-based nurture messaging achieves up to 30% higher engagement than traditional outreach approaches.
All messages are written at a 5th-grade reading level for member ease, and quick and easy regulatory approvals by states.
Positions plans to be fully operational ahead of July–September 2026 testing and December 2026 compliance deadlines.
GoMo Health has earned HITRUST r2 certification for Personal Concierge and GoMo Chat products on Microsoft Azure.

What This Means

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  • Large-scale outreach attempts to reach Medicaid members via multiple channels.
  • Processing and authenticating high volumes of documentation.
  • Building dynamic cross-sector coordination systems to capture member work, volunteer, and exemption documentation.
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  • Nurturing and educating members to prevent avoidable coverage loss.
  • Communicating with members at scale.
  • Navigating individual state requirements and timelines.

We’re here to help you find the right approach for your organization.

See how the platform works in practice – and how the program components can be deployed independently or integrated end‑to‑end.