Georgia HB 1276: Community Health, Department of; review information from certain sources to determine and verify eligibility of Medicaid recipients; provide

Bill Text

26 LC 52 1051S
The House Committee on Health offers the following substitute to HB 1276:
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public1
assistance, so as to provide for the Department of Human Services to regularly and2
systematically review information from certain sources to determine and verify eligibility of3
Medicaid recipients; to prohibit self-attestation of certain eligibility factors; to provide for4
consent to disclosure of certain information; to provide for Medicaid program integrity5
measures; to provide for certain state agencies to submit information to the department; to6
provide for the department to request information from certain federal agencies; to provide7
for the review of data; to provide for the removal of ineligible recipients; to provide for8
eligibility redeterminations; to provide for retroactive eligibility; to provide for annual9
reports; to provide for supplemental data to such reports; to provide for related matters; to10
provide for the Department of Community Health to submit a state plan amendment or11
waiver request; to provide for an effective date; to repeal conflicting laws; and for other12
purposes.13
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:14
H. B. 1276 (SUB)
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26 LC 52 1051S
SECTION 1.15
Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance,16
is amended by adding a new article to read as follows:17
"ARTICLE 1018
49-4-200.19
(a) Except as required under federal law, self-attestation shall not be accepted for any of20
the following in the administration of the Medicaid program pursuant to Article 7 of this21
chapter without verification prior to enrollment:22
(1) Income;23
(2) Residency;24
(3) Identity;25
(4) Household composition; and26
(5) Citizenship or immigration status.27
(b) Except as required under federal law, a condition of eligibility for assistance shall be28
that a Medicaid recipient consent to the disclosure of information about such individual's29
income, residency, identity, household composition, and citizenship or immigration status. 30
Such consent shall be effective to authorize any state or federal agency to release such31
information requested by the department as provided for in this article.32
49-4-201.33
The Department of Community Health and the department shall coordinate the issuing of34
requests to applicable state agencies and federal agencies for information relating to35
Medicaid eligibility data, including, but not limited to:36
(1) Medicaid recipient identity verification;37
(2) Medicaid recipient death verification;38
H. B. 1276 (SUB)
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26 LC 52 1051S
(3) Employment and wages;39
(4) Lottery winnings;40
(5) Residency verification, including residency relating to concurrent enrollment in41
Medicaid programs in other states;42
(6) Household composition;43
(7) Medicaid recipient incarceration status;44
(8) Third-party liability verification;45
(9) Asset verification; and46
(10) Any other data the Department of Community Health or the department considers47
appropriate in order to strengthen program integrity, reduce costs, and reduce fraud,48
waste, and abuse in the Medicaid program.49
49-4-202.50
(a) The department shall enter into any data-sharing agreements or memorandums of51
understanding with any state or federal agencies necessary to effectuate the provisions of52
this article.53
(b) The department shall develop a form, identify information, and establish a schedule for54
the Department of Labor, Department of Revenue, and Department of Corrections to55
submit information to the department as provided for in Code Section 49-4-203.56
(c) The department shall be authorized to contract with an independent third party for57
database searches that may contain information that may indicate a change in58
circumstances affecting Medicaid recipient eligibility.59
49-4-203.60
(a) No later than January 1, 2027, and on a monthly basis thereafter, the Department of61
Corrections shall submit information concerning Medicaid recipients, including regarding62
incarceration, to the department.63
H. B. 1276 (SUB)
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(b) No later than January 1, 2027, and on a quarterly basis thereafter, the Department of64
Labor and the Department of Revenue shall submit information concerning Medicaid65
recipients, including changes to employment or wages, to the department.66
(c) No later than January 1, 2027, and on an annual basis thereafter, the Department of67
Revenue shall submit information concerning Medicaid recipients, including adjusted gross68
income and family composition, to the department.69
(d) The department shall promptly review the information received pursuant to subsections70
(a), (b), and (c) of this Code section for indications of changes in circumstances affecting71
Medicaid recipient eligibility and shall take any actions provided for in Code Section72
49-4-206 as necessary.73
49-4-20