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OBBBA work requirements · Nebraska pilot May 2026 · National Jan 1, 2027 · Don't wait
medfrail.com
OBBBA work requirements · Jan 1, 2027 · you may already qualify for an exemption

Most people who lost Medicaid under work requirements actually qualified.

In Arkansas's 2018 pilot — the only state to implement work requirements before courts struck them down — 95% of people who lost coverage were working, exempt, or both. They failed the paperwork, not the requirement. We generate the physician-signed medical frailty attestation. You keep your coverage.

50-state licensed physicians · HIPAA-compliant · 24-hr turnaround · audit-ready PDF
“But am I actually frail?” Most people picture someone much sicker than themselves — and lose coverage they qualified for. Tap through the same 9-level scale physicians use. Sixty seconds, and you’ll know what the word actually means. ↓
the stakes

Up to 10.1 million people could lose Medicaid by 2028.

Most of them qualify for an exemption. The problem is documentation, not eligibility. In Arkansas's 2018 pilot, 95% of people who lost coverage were exempt or working — they failed the paperwork, not the requirement. The same failure is about to happen at national scale.

62%
health impairs work
Projected coverage loss for people whose self-reported health condition inhibits their ability to work, under low-mitigation state scenarios.
52%
caregiver families
Projected coverage loss for people living with a disabled family member they may serve as caregiver for, under low-mitigation scenarios.
73%
self-employed
Projected coverage loss among self-employed Medicaid enrollees — states cannot automatically verify 1099 income.
Source: Urban Institute / Robert Wood Johnson Foundation · March 2026
For discharge planners and case managers

Identify patients who need structured home support before they leave your facility.

medfrail.com generates a physician-signed frailty attestation that travels with the patient. It documents the care gap so your team, the patient's family, and any home care service all start from the same baseline. Fewer calls back. Fewer readmissions.

Partner with us on discharge documentation
For families

Know what to watch for in the first week home.

The 72 hours after hospital discharge are the highest-risk window. A frailty attestation is the first step — it documents your family member's condition and flags which daily activities are at risk. Use it to structure care, qualify for HSA/FSA coverage, and brief any home caregiver on exactly what matters.

Get an attestation for my family member
the process

Three steps. One physician. Twenty-four hours.

Every attestation is reviewed and signed by a licensed physician matched to your condition.

quick self-check

Tap every category that applies to you. See your likely exemption status.

Federal law names eight categories. You only need one. This is not a medical or legal determination — it is an orientation. A physician makes the actual assessment when you start.

This self-check is educational, not a legal or medical determination. One selected category is sufficient to start the attestation process. A licensed physician makes the final determination.

what "medical frailty" actually means

Frailty is not a feeling. It's a measured clinical state.

Clinicians describe frailty on a 1-to-9 scale — from very fit to terminally ill. Move through it below to see what each level means for daily life, and what it implies for care planning. This is the same vocabulary a physician uses when writing your attestation.

Tap a level · 1 = very fit  →  9 = terminally ill

Educational illustration of the Clinical Frailty Scale (Rockwood et al., Canadian Study of Health and Aging). Plain-language summary only — not a diagnosis. A frailty level is assigned by a clinician reviewing your full history.
medfrail.com matches you to a licensed physician who makes that assessment for your attestation.

three paths in

Enrollees, health plans, and providers — same attestation engine.

for enrollees

I might lose my Medicaid.

You've heard about the new work requirements and you're worried. Upload your records, we match you to a licensed physician, you get a signed attestation in 24 hours.

$99 · direct pay
Start mine →
for medicaid mcos

My members are at risk.

Every enrollee who churns off costs you capitation revenue. medfrail.com is built to clear frail members through exemption at scale — protecting your book without your staff doing the work.

$49–99 · per attestation · volume-tiered
Plan partnership →
for fqhcs + hospitals

My patients need documentation.

Your safety-net patients maintain coverage and you maintain reimbursement. We plug into your EHR, generate attestations for your frail panel, your revenue cycle stays intact.

$49 · per attestation · annual contract
Provider partnership →
the architecture

Built for defensibility. Made to scale.

Public face
medfrail.com — consumer-facing intake, MCO/provider contract portal
this page
Platform
ClinicalSwipe — review marketplace · specialty routing · audit trail · attestation log
infrastructure
Clinical authority
altru.care — 50-state licensed attending physician · first named attesting physician
supply
Reviewer network
Specialty-matched panel — psychiatry, PMR, addiction medicine, primary care, cardiology
scale
Start my attestation · $99
We are not legal representatives. We generate medical documentation reviewed and signed by licensed physicians. Final eligibility determinations are made by your state Medicaid agency.
the honest part

What our physician of record signs — and what they won't.

Our physician of record handles medfrail attestations. A physician drafts “if appropriate” — and that phrase is doing real work. Here is what it means.

he signs
  • Attestations the record supports. A licensed physician reviews your file and — if appropriate — drafts an attestation against the federal OBBBA medical frailty criteria.
  • Any of the eight federal categories. Disability, serious or complex medical condition, substance use disorder, disabling mental disorder, caregiving role, pregnancy or postpartum, foster youth, veteran with total disability. You only need one.
  • Audit-ready documents. A signed, timestamped PDF with citation to the specific OBBBA criteria you meet.
  • Only what a physician has reviewed. Every attestation is reviewed and signed by a licensed physician — none is submitted without that signature.
he won't sign
  • Files with a documentation gap. A draft that doesn’t hold up goes back for clarification or additional records — not into the signature queue.
  • Frailty where there isn’t any. On the 1–9 clinical frailty scale above, levels 1–3 — very fit, fit, managing well — are unlikely to qualify.
  • Your state’s decision. Final eligibility determinations are made by your state Medicaid agency — an attestation is evidence, not a verdict.
  • Legal representation. We are not legal representatives. We generate medical documentation reviewed and signed by licensed physicians.

Start your attestation. Keep your coverage.

AI-drafted. Reviewed and signed by a licensed physician. Delivered in 24 hours.

✓ We'll contact you within 2 hours with next steps.
50-state licensed physician · HIPAA-compliant · audit-ready PDF
after your attestation

You kept your coverage. Now keep your independence.

A medical frailty attestation documents your condition — it doesn't improve it. If daily activities are harder than they used to be, co-op.care provides in-home support from caregivers who are paid fairly and accountable to you — not to a staffing agency.

Explore home care at co-op.care
co-op.care includes
  • + In-home personal care and daily living support
  • + Caregivers who are W-2 employees, not gig workers
  • + HSA/FSA-eligible with a physician Letter of Medical Necessity
  • + Care coordination through Sage AI — no paperwork, no runaround