Alabama 2025 Regular Session

Alabama Senate Bill SB245 Compare Versions

Only one version of the bill is available at this time.

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1	1	SB245INTRODUCED
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3	3	SB245
4	4	MU5IHWW-1
5	5	By Senator Orr
6	6	RFD: Finance and Taxation General Fund
7	7	First Read: 18-Mar-25
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12	12	5 MU5IHWW-1 03/10/2025 GP (L)lg 2025-126
13	13	Page 1
14	14	First Read: 18-Mar-25
15	15	SYNOPSIS:
16	16	This bill would prohibit the Alabama Medicaid
17	17	Agency (the agency) from accepting certain self
18	18	attestations or eligibility determinations for
19	19	Medicaid.
20	20	This bill would require the agency to enter into
21	21	data matching agreements with certain state agencies to
22	22	cross-check Medicaid eligibility with other data
23	23	relating to income, employment, assets, and other
24	24	relevant information.
25	25	This bill would require the Department of Human
26	26	Resources (the department) to enter into data matching
27	27	agreements with certain state agencies to cross-check
28	28	food assistance eligibility with other data relating to
29	29	income, employment, assets, and other relevant
30	30	information.
31	31	This bill would require the agency and the
32	32	department to regularly review certain related federal
33	33	data to assess continued eligibility for public
34	34	assistance and, if necessary, act on any changes.
35	35	This bill would require the agency and the
36	36	department to regularly publish data relating to
37	37	investigations of fraud and noncompliance.
38	38	This bill would also require the agency and the
39	39	department to adopt rules.
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69	69	department to adopt rules.
70	70	A BILL
71	71	TO BE ENTITLED
72	72	AN ACT
73	73	Relating to public assistance; to provide further for
74	74	eligibility determinations for Medicaid; to prohibit certain
75	75	self attestations for Medicaid eligibility; to require the
76	76	Alabama Medicaid Agency to enter into data matching agreements
77	77	with certain state agencies to cross-check Medicaid
78	78	eligibility; to require the Department of Human Resources to
79	79	enter into data matching agreements with certain state
80	80	agencies to cross-check food assistance eligibility; to
81	81	require the agency and the department to regularly review
82	82	certain federal data for purposes of confirming eligibility
83	83	for public assistance; to require the agency and the
84	84	department to publicize data related to investigations of
85	85	fraud; and to require the agency and the department to adopt
86	86	rules.
87	87	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
88	88	Section 1. (a) For the purposes of this section, the
89	89	term "eligibility" refers to eligibility for participation in
90	90	or receipt of benefits from Medicaid.
91	91	(b)(1) The Alabama Medicaid Agency may not accept
92	92	eligibility determinations from an Exchange established under
93	93	42 U.S.C. § 18041(c).
94	94	(2) The agency may accept assessments from an Exchange
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124	124	(2) The agency may accept assessments from an Exchange
125	125	established under 42 U.S.C. § 18041(c), provided that the
126	126	agency verifies eligibility and makes eligibility
127	127	determinations.
128	128	(c) Except where required by federal law, the Alabama
129	129	Medicaid Agency may not:
130	130	(1) Accept self-attestation of income, residency, age,
131	131	household composition, caretaker or relative status, or
132	132	receipt of other coverage without verifying that information
133	133	prior to enrollment; or
134	134	(2) Request the authority to waive or decline to
135	135	periodically check any available income-related data sources
136	136	to verify eligibility.
137	137	(d) The Alabama Medicaid Agency shall enter into data
138	138	matching agreements to receive and review information that may
139	139	indicate a change in circumstances that may affect eligibility
140	140	and cross-check households enrolled in Medicaid with other
141	141	state data sets as follows:
142	142	(1) On at least a monthly basis, information from each
143	143	of the following:
144	144	a. The Alabama Department of Public Health, including,
145	145	but not limited to, death records.
146	146	b. The Department of Human Resources, including, but
147	147	not limited to, potential changes in residency as identified
148	148	by out-of-state electronic benefit (EBT) transactions.
149	149	c. The Department of Corrections, including, but not
150	150	limited to, incarceration status.
151	151	(2) On at least a quarterly basis, information from
152	152	each of the following:
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182	182	each of the following:
183	183	a. The Department of Workforce, including, but not
184	184	limited to, changes in employment, income, wages, assets, or
185	185	disability status.
186	186	b. The Department of Revenue, including, but not
187	187	limited to, potential changes in income, wages, or residency
188	188	as identified by tax records.
189	189	(e) At least once a month, the Alabama Medicaid Agency
190	190	must assess continued eligibility and act on any changes that
191	191	may affect eligibility based on a review of data from the
192	192	following federal sources:
193	193	(1) From the United States Social Security
194	194	Administration, earned income information, death register
195	195	information, incarceration records, supplemental security
196	196	income information, beneficiary records, earnings information,
197	197	and pension information.
198	198	(2) From the United States Department of Health and
199	199	Human Services, income and employment information maintained
200	200	in the National Directory of New Hires database and child
201	201	support enforcement data.
202	202	(3) From the United States Department of Housing and
203	203	Urban Development, payment and earnings information.
204	204	(4) From the United States Federal Bureau of
205	205	Investigation, national fleeing felon information.
206	206	(f) On at least a quarterly basis, the Alabama Medicaid
207	207	Agency shall make available on its public website all of the
208	208	following data from findings on noncompliance and fraud
209	209	investigations, provided the data is presented in the
210	210	aggregate and does not include confidential or personally
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240	240	aggregate and does not include confidential or personally
241	241	identifying information:
242	242	(1) The number of Medicaid cases investigated for
243	243	intentional program violations or fraud.
244	244	(2) The total number of Medicaid cases referred to the
245	245	Attorney General's office for prosecution.
246	246	(3) Improper payments and expenditures.
247	247	(4) Monies received.
248	248	(5) Aggregate data concerning improper payments and
249	249	ineligible recipients as a percentage of those investigated
250	250	and reviewed.
251	251	(g) The Alabama Medicaid Agency shall adopt rules to
252	252	implement and administer this section.
253	253	Section 2. (a) For the purposes of this section, the
254	254	term "eligibility" refers to eligibility for food assistance,
255	255	including the Supplemental Nutrition Assistance Program
256	256	(SNAP).
257	257	(b) The Department of Human Resources shall enter into
258	258	data matching agreements to receive and review information
259	259	that may indicate a change in circumstances that may affect
260	260	eligibility and cross-check households enrolled in food
261	261	assistance with other state data sets as follows:
262	262	(1) On at least a monthly basis, information from each
263	263	of the following:
264	264	a. The Alabama Department of Public Health, including,
265	265	but not limited to, death records.
266	266	b. The Department of Human Resources, including, but
267	267	not limited to, potential changes in residency as identified
268	268	by out-of-state electronic benefit (EBT) transactions.
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298	298	by out-of-state electronic benefit (EBT) transactions.
299	299	c. The Department of Corrections, including, but not
300	300	limited to, incarceration status.
301	301	(2) On at least a quarterly basis, information from
302	302	each of the following:
303	303	a. The Department of Workforce, including, but not
304	304	limited to, changes in employment, income, wages, assets, or
305	305	disability status.
306	306	b. The Department of Revenue, including, but not
307	307	limited to, potential changes in income, wages, or residency
308	308	as identified by tax records.
309	309	(c) At least once a month, the Department of Human
310	310	Resources must assess continued eligibility and act on any
311	311	changes that may affect eligibility based on a review of data
312	312	from the following federal sources:
313	313	(1) From the United States Social Security
314	314	Administration, earned income information, death register
315	315	information, incarceration records, supplemental security
316	316	income information, beneficiary records, earnings information,
317	317	and pension information.
318	318	(2) From the United States Department of Health and
319	319	Human Services, income and employment information maintained
320	320	in the National Directory of New Hires database and child
321	321	support enforcement data.
322	322	(3) From the United States Department of Housing and
323	323	Urban Development, payment and earnings information.
324	324	(4) From the United States Federal Bureau of
325	325	Investigation, national fleeing felon information.
326	326	(d) On at least a quarterly basis, the Department of
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356	356	(d) On at least a quarterly basis, the Department of
357	357	Human Resources shall make available on its public website all
358	358	of the following data from findings on noncompliance and fraud
359	359	investigations, provided the data is presented in the
360	360	aggregate and does not include confidential or personally
361	361	identifying information:
362	362	(1) The number of households investigated for
363	363	intentional program violations or fraud.
364	364	(2) The total number of households referred to the
365	365	Attorney General's office for prosecution.
366	366	(3) Improper payments and expenditures.
367	367	(4) Monies received.
368	368	(5) Aggregate data concerning improper payments and
369	369	ineligible recipients as a percentage of those investigated
370	370	and reviewed.
371	371	(6) The aggregate amount of funds expended by EBT
372	372	transactions in each state outside of Alabama.
373	373	(e) The Department of Human Resources shall adopt rules
374	374	to implement and administer this section.
375	375	Section 3. This act shall become effective on October
376	376	1, 2025.
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