States are entering the first phase of implementing new federal Medicaid work requirements, with Nebraska becoming the first state where some beneficiaries are beginning to lose coverage after failing to meet the reporting requirements.

Nebraska is the first state to implement the requirements ahead of the Jan. 1 national deadline.

About 200 Medicaid beneficiaries are expected to lose coverage this week after failing to report qualifying activities, with each case undergoing multiple reviews before notifications are issued, according to a report published Monday by Axios, which cited the state's Medicaid director.

Under the federal rules, certain Medicaid beneficiaries must complete at least 80 hours per month of qualifying work, education, community service or other approved activities, or qualify for an exemption, to maintain coverage.

States are also required to verify compliance and generally provide beneficiaries with a 30-day notice period before terminating coverage, according to the Centers for Medicare & Medicaid Services (CMS).