Eligible people are about to lose Medicaid over paperwork. We make sure they don't.
When H.R.1's work requirements take effect, most coverage loss won't come from non-compliance — it'll come from confusion: missed notices, language barriers, and unclaimed exemptions. The eligibility-system vendors are building the engines that decide who qualifies. We build the part they didn't — plain-language, multilingual member communications, exemption education, and an "Am I exempt?" member assistant.
The clock that matters is this summer. Every in-scope state must send enrollee notices — by mail plus at least one additional channel — covering compliance, exemptions, consequences, and reporting between June 30 and August 31, 2026. Federal enforcement begins January 1, 2027.
Procedural disenrollment, not non-compliance
The last time work requirements ran, the people who lost coverage weren't the people who refused to work. They were the people who never understood what they had to do. That is a communications failure — and it is preventable.
Based on our review of announced implementation awards (June 2026), the major eligibility-system primes have committed more than $600M to verification engines, frailty logic, and fraud tools — and none had a priced member-communications product. The system that decides eligibility is being built. The bridge that gets eligible members across it is not.
And the risk just doubled: under the new law, expansion adults must renew every six months instead of annually — twice as many moments a member can fall off coverage over paperwork.
The same notice. One keeps the member enrolled.
For a member-communications vendor, the writing is the product. Here's what members get today — and what we send instead, across mail, SMS, and IVR.
What members get today
RE: NOTICE OF COMMUNITY ENGAGEMENT REQUIREMENT DETERMINATION — CASE #4471-A. PURSUANT TO 42 C.F.R. AND STATE PLAN AMENDMENT 26-014, BENEFICIARIES AGED 19–64 IN THE ADULT EXPANSION GROUP MUST DEMONSTRATE QUALIFYING COMMUNITY ENGAGEMENT ACTIVITIES OF NOT LESS THAN EIGHTY (80) HOURS PER CALENDAR MONTH, OR ESTABLISH ENTITLEMENT TO AN EXEMPTION CATEGORY AS ENUMERATED IN SECTION 1115(d)(3) HEREOF.
FAILURE TO TIMELY SUBMIT VERIFICATION VIA THE DESIGNATED PORTAL OR IN-PERSON OFFICE PRIOR TO THE LAST BUSINESS DAY OF THE REPORTING PERIOD MAY RESULT IN SUSPENSION AND/OR TERMINATION OF MEDICAL ASSISTANCE BENEFITS WITHOUT FURTHER NOTICE, SUBJECT TO FAIR HEARING RIGHTS AS DESCRIBED IN ATTACHMENT C…
Composite of real state notice language. 11th-grade+ reading level, no deadline date, exemptions buried.
What we send instead
Keep your Medicaid: one thing to do this month
You now need to report 80 hours of work, school, training, or volunteering each month — or tell us you're exempt.
6th-grade reading level · deadline up front · exemptions first · English + Spanish, same envelope.
The SMS that follows the letter
The IVR script for members who call
System"To keep your Medicaid, you may need to report work hours — or you may be exempt. To check if you're exempt in under a minute, press 1."
Member[presses 1]
System"Do you take care of a child under 14? Press 1 for yes…"
System"Good news — you likely qualify for an exemption. We've flagged your file and you'll get a confirmation letter. Nothing else to do today."
Synthetic samples for illustration — not issued by any state. Every engagement is built to your state's approved notice requirements and CMS guidance, comprehension-tested before it ships.
The member-engagement specialists the primes and health plans plug in
We don't compete with the eligibility-system vendors — we complete them. Everything we build is CMS-compliant, member-comprehension-tested, and delivered in English and Spanish at native quality.
Plain-language notices
CMS-compliant enrollee notices rewritten so members actually understand what they must do, by when, and what happens if they don't — across mail, SMS, and IVR.
Exemption education
The eligible-but-confused caregiver, pregnant member, or person in treatment is the one who churns. We get them to claim the exemption they already qualify for.
Multilingual outreach
Native-quality Spanish and additional languages — built and delivered at scale through our nearshore production line, not machine-translated.
"Am I exempt?" assistant
A plain-language member assistant that answers "Do I need to report?" and "Am I exempt?" and routes the member to the right next step.
Managed outreach
Ongoing, measured SMS / IVR / mail campaigns tied to a retention KPI — your engagement layer, run for you.
Reporting & comprehension testing
Response rates, exemption claim rates, and disenrollment-risk segmentation — so you can prove the coverage you protected.
From "we have a deadline" to live outreach in weeks
A fast, fixed-scope start that earns the right to a managed program — no long procurement required to begin.
Size the exposure
We quantify the coverage and premium dollars at risk for your population, and pinpoint where members will fall through — by notice, language, and step.
Build the notices & outreach
CMS-compliant, plain-language, English/Spanish notices, SMS/IVR scripts, exemption guides, and an "Am I exempt?" flow — comprehension-tested.
Run it & measure
We deliver the campaign and report response rates, exemption claims, and disenrollment-risk segments — so you can prove the coverage you protected.
Two buyers, one capability
Health plans feel coverage churn as lost premium, month after month. States and their prime contractors are on the hook for the federal notice mandate. We serve both — and we team with the systems vendors rather than fight them.
Medicaid health plans (MCOs)
Every procedurally-disenrolled member is lost capitation premium. We protect enrolled lives with multilingual retention outreach your team can't staff fast enough. For health plans → · See your exposure →
Eligibility-system primes
You own the contract vehicle and the verification engine. We're the multilingual member-communications subcontractor that de-risks your Aug 31 outreach deliverable. Team with us →
State Medicaid agencies
CMS-compliant, plain-language, multilingual notices and exemption campaigns — delivered on the mandate timeline, via your existing vehicle or your prime. For state agencies →
FQHCs & primary care associations
Turnkey multilingual exemption-screening and member-education packs for the trusted community messengers states want involved.
We didn't just write about this problem — we proposed to solve it for a state
Our team submitted a proposal to a state Medicaid agency for H.R.1 community-engagement and work-requirement member communications. This is the exact work — not an adjacent capability.
Before building this, our leadership delivered large-scale communications, technology, and program work — the same disciplines coverage retention demands — for enterprise and public-sector organizations, including:
Reflects prior engagements led by members of our leadership team; named as representative past performance, not as endorsements of this venture. Detailed references and methodology available on request under appropriate confidentiality terms.
Built to the state outreach scope of work — end to end
State Medicaid outreach contracts (e.g., Illinois HFS's H.R.1 "HRI Project") require a full-service communications partner. We deliver — or subcontract into — every line of that scope.
- Audience research & segmentation for impacted, priority & hard-to-reach populations
- Plain-language messaging for diverse Medicaid populations
- Creative development & accessible production
- Media planning & buying (pass-through at cost, no markup)
- Translation & language access services
- Digital & social media + geofenced ads at clinics, DSS offices, transit & food banks
- TCPA-compliant SMS/IVR (consent & opt-out) — HHS marketing-rule aware
- Equity KPI reporting — disaggregated by language, geography & disability
- Accessibility — Section 508, IITAA & ADA; CBO trusted-messenger partnerships
- Work-for-hire deliverables; full agency review/approval workflow
Prime contractors: we're your multilingual member-engagement & plain-language subcontractor — and we help you meet BEP / diversity participation goals. Team with us →
The rare mix this problem requires: technology, Medicaid, policy, and marketing
Most vendors are strong in one lane. Keeping eligible members enrolled takes all four at once — the systems fluency to work alongside eligibility platforms, the policy command to get the rules right, and the marketing craft to make members actually understand and act.
Tejune is a Harvard Business School alumnus and a technology and marketing executive with 26+ years at the intersection of technology, marketing, and international business growth. He took 6D Global Technologies public on the NASDAQ and has led expansion across the US, Asia, Latin America, Europe, and Africa. A YPO member who has served on boards across multiple industries and continents — and who also studied at Singularity University and Stanford Executive Education — he sets the strategy for turning complex Medicaid policy into clear, multilingual communication that keeps eligible people enrolled.
Jeff is an operations and delivery leader with deep experience running healthcare and managed-care programs at scale. He specializes in standing up compliant, high-volume member-engagement operations — outreach, call-center workflows, reporting, and quality — and translating regulatory requirements into dependable day-to-day execution. He leads delivery for every engagement.
Together, deep in technology, Medicaid, policy, and marketing — built specifically to prevent avoidable, procedural coverage loss.
A full delivery team stands up around every engagement
We are a project-based firm. Every engagement is staffed with a dedicated, U.S.-led team across the six functions below, drawn from our vetted specialist network — so plans and agencies get senior depth across policy, language, compliance, and production without carrying the overhead.
Engagement & Delivery Lead
Owns the engagement end to end — scope, timeline, and the federal notice-window deadline. Typically a program manager with healthcare or public-sector delivery experience who runs the workplan, coordinates the specialist team, and is the single point of accountability for the client.
Plain-Language & Creative Lead
Turns dense CMS and state rules into notices members can read and act on at a 4th–6th grade level. A content strategist/health-literacy specialist who designs the notice set, member journeys, and accessible creative — measured by whether members understand and respond.
Language Access Lead
Delivers native-quality translation and localization in each population's top languages — Spanish first, plus the locally-dominant languages. A bilingual linguist who manages human translation, community review, and telephonic/in-person interpretation — never machine translation alone.
Multichannel Outreach Manager
Runs the omnichannel campaign — mail, SMS, IVR, email, and trusted-messenger (CBO/FQHC) outreach — sequenced so it stops the moment a member responds. Experienced in TCPA-compliant SMS/IVR, consent management, and high-volume member contact operations.
Compliance & Accessibility Lead
Keeps every deliverable inside the perimeter — Section 508, IITAA, ADA, and WCAG 2.1 AA, plus TCPA and HHS marketing rules. Reviews notices, scripts, and portals for accessibility and regulatory conformance before anything reaches a member.
Data & Equity Reporting Analyst
Builds the measurement layer — baselines and KPIs (reach, exemption capture, reporting completion, ex-parte renewal) disaggregated by language, geography, and disability — so the program proves coverage-retention impact, not just activity.
Roles describe the functions staffed on each engagement from our specialist network; specific team members are assigned and named per contract. Key-personnel résumés provided with proposals on request.
The 2027 Medicaid Coverage Retention Report
The federal mandate, the financial-exposure model, the member-journey failure map, the channel & exemptions playbooks, and a 50-state implementation & RFP/procurement intelligence appendix — the brief your team needs before the August 31 notice deadline. Enter your work email and download instantly.
Engagements that fit the deadline you're facing
Most relationships start with a fixed-scope, fast diagnostic and grow into managed outreach. Start where your pressure is.
Coverage-Loss Exposure Calculator
See the premium / coverage dollars you have at risk. Free, instant.
Aug 31 Notice & Outreach Rapid Pack
CMS-compliant EN/ES notices, SMS/IVR scripts, and exemption one-pagers — built to close inside the mandate window.
Procedural Disenrollment Risk Audit
Notice & member-journey review, gap analysis, multilingual sample pack, and a remediation roadmap.
Churn-Prevention Pilot
A 90-day multilingual outreach + exemption campaign tied to a measured retention KPI.
Engagement Layer, Managed
Your ongoing multilingual member-retention outreach, run and measured for you.
What buyers ask first
What are Medicaid work requirements under H.R.1?
H.R.1 (signed July 4, 2025) requires many Medicaid expansion adults to complete about 80 hours/month of work, volunteering, or education and to report it. States must implement by January 1, 2027, with a federally-mandated enrollee-notice window of June 30–August 31, 2026.
Why do eligible people lose coverage?
Most loss is procedural, not eligibility-based. In Arkansas's 2018–19 program, ~18,000 people lost coverage — mostly from confusion, missed notices, and unclaimed exemptions, not from failing to work. Clear, multilingual communication prevents that.
Do you compete with Maximus, Gainwell, or Deloitte?
No. We don't build eligibility or verification systems. We're the member-communications layer on top of them — and we frequently work as a subcontractor to the primes who need multilingual outreach they don't staff in-house.
How much does procedural disenrollment cost a health plan?
Every procedurally-disenrolled member is lost capitation premium each month. A plan with 100,000 subject members at $450 PMPM and 18% procedural churn has ~$100M/yr at risk. Estimate your exposure →
What's the fastest way to start before August 31?
The Aug 31 Notice & Outreach Rapid Pack delivers CMS-compliant EN/ES notices, SMS/IVR scripts, and exemption one-pagers in 2–3 weeks — built to land inside the federal notice window.
Can you work through our existing contract or prime?
Yes. We engage directly with health plans and states, or as a subcontractor to your eligibility-system prime — whichever path is fastest for your timeline.
Get the Medicaid work-requirement updates that matter.
Plain-language updates on deadlines, exemptions, and state implementation. No spam, unsubscribe anytime.
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Who is delivering your Aug 31 member-notice obligation?
Tell us your state and population and we'll send back a quick read on your exposure and the fastest compliant path — usually within one business day.
- No obligation, no procurement required to talk
- We can engage directly or as a subcontractor to your prime
- Built for the deadline, delivered in plain language
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