SB245INTRODUCED
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SB245
MU5IHWW-1
By Senator Orr
RFD: Finance and Taxation General Fund
First Read: 18-Mar-25
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5 MU5IHWW-1 03/10/2025 GP (L)lg 2025-126
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First Read: 18-Mar-25
SYNOPSIS:
This bill would prohibit the Alabama Medicaid
Agency (the agency) from accepting certain self
attestations or eligibility determinations for
Medicaid.
This bill would require the agency to enter into
data matching agreements with certain state agencies to
cross-check Medicaid eligibility with other data
relating to income, employment, assets, and other
relevant information.
This bill would require the Department of Human
Resources (the department) to enter into data matching
agreements with certain state agencies to cross-check
food assistance eligibility with other data relating to
income, employment, assets, and other relevant
information.
This bill would require the agency and the
department to regularly review certain related federal
data to assess continued eligibility for public
assistance and, if necessary, act on any changes.
This bill would require the agency and the
department to regularly publish data relating to
investigations of fraud and noncompliance.
This bill would also require the agency and the
department to adopt rules.
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department to adopt rules.
A BILL
TO BE ENTITLED
AN ACT
Relating to public assistance; to provide further for
eligibility determinations for Medicaid; to prohibit certain
self attestations for Medicaid eligibility; to require the
Alabama Medicaid Agency to enter into data matching agreements
with certain state agencies to cross-check Medicaid
eligibility; to require the Department of Human Resources to
enter into data matching agreements with certain state
agencies to cross-check food assistance eligibility; to
require the agency and the department to regularly review
certain federal data for purposes of confirming eligibility
for public assistance; to require the agency and the
department to publicize data related to investigations of
fraud; and to require the agency and the department to adopt
rules.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For the purposes of this section, the
term "eligibility" refers to eligibility for participation in
or receipt of benefits from Medicaid.
(b)(1) The Alabama Medicaid Agency may not accept
eligibility determinations from an Exchange established under
42 U.S.C. § 18041(c).
(2) The agency may accept assessments from an Exchange
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(2) The agency may accept assessments from an Exchange
established under 42 U.S.C. § 18041(c), provided that the
agency verifies eligibility and makes eligibility
determinations.
(c) Except where required by federal law, the Alabama
Medicaid Agency may not:
(1) Accept self-attestation of income, residency, age,
household composition, caretaker or relative status, or
receipt of other coverage without verifying that information
prior to enrollment; or
(2) Request the authority to waive or decline to
periodically check any available income-related data sources
to verify eligibility.
(d) The Alabama Medicaid Agency shall enter into data
matching agreements to receive and review information that may
indicate a change in circumstances that may affect eligibility
and cross-check households enrolled in Medicaid with other
state data sets as follows:
(1) On at least a monthly basis, information from each
of the following:
a. The Alabama Department of Public Health, including,
but not limited to, death records.
b. The Department of Human Resources, including, but
not limited to, potential changes in residency as identified
by out-of-state electronic benefit (EBT) transactions.
c. The Department of Corrections, including, but not
limited to, incarceration status.
(2) On at least a quarterly basis, information from
each of the following:
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each of the following:
a. The Department of Workforce, including, but not
limited to, changes in employment, income, wages, assets, or
disability status.
b. The Department of Revenue, including, but not
limited to, potential changes in income, wages, or residency
as identified by tax records.
(e) At least once a month, the Alabama Medicaid Agency
must assess continued eligibility and act on any changes that
may affect eligibility based on a review of data from the
following federal sources:
(1) From the United States Social Security
Administration, earned income information, death register
information, incarceration records, supplemental security
income information, beneficiary records, earnings information,
and pension information.
(2) From the United States Department of Health and
Human Services, income and employment information maintained
in the National Directory of New Hires database and child
support enforcement data.
(3) From the United States Department of Housing and
Urban Development, payment and earnings information.
(4) From the United States Federal Bureau of
Investigation, national fleeing felon information.
(f) On at least a quarterly basis, the Alabama Medicaid
Agency shall make available on its public website all of the
following data from findings on noncompliance and fraud
investigations, provided the data is presented in the
aggregate and does not include confidential or personally
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aggregate and does not include confidential or personally
identifying information:
(1) The number of Medicaid cases investigated for
intentional program violations or fraud.
(2) The total number of Medicaid cases referred to the
Attorney General's office for prosecution.
(3) Improper payments and expenditures.
(4) Monies received.
(5) Aggregate data concerning improper payments and
ineligible recipients as a percentage of those investigated
and reviewed.
(g) The Alabama Medicaid Agency shall adopt rules to
implement and administer this section.
Section 2. (a) For the purposes of this section, the
term "eligibility" refers to eligibility for food assistance,
including the Supplemental Nutrition Assistance Program
(SNAP).
(b) The Department of Human Resources shall enter into
data matching agreements to receive and review information
that may indicate a change in circumstances that may affect
eligibility and cross-check households enrolled in food
assistance with other state data sets as follows:
(1) On at least a monthly basis, information from each
of the following:
a. The Alabama Department of Public Health, including,
but not limited to, death records.
b. The Department of Human Resources, including, but
not limited to, potential changes in residency as identified
by out-of-state electronic benefit (EBT) transactions.
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by out-of-state electronic benefit (EBT) transactions.
c. The Department of Corrections, including, but not
limited to, incarceration status.
(2) On at least a quarterly basis, information from
each of the following:
a. The Department of Workforce, including, but not
limited to, changes in employment, income, wages, assets, or
disability status.
b. The Department of Revenue, including, but not
limited to, potential changes in income, wages, or residency
as identified by tax records.
(c) At least once a month, the Department of Human
Resources must assess continued eligibility and act on any
changes that may affect eligibility based on a review of data
from the following federal sources:
(1) From the United States Social Security
Administration, earned income information, death register
information, incarceration records, supplemental security
income information, beneficiary records, earnings information,
and pension information.
(2) From the United States Department of Health and
Human Services, income and employment information maintained
in the National Directory of New Hires database and child
support enforcement data.
(3) From the United States Department of Housing and
Urban Development, payment and earnings information.
(4) From the United States Federal Bureau of
Investigation, national fleeing felon information.
(d) On at least a quarterly basis, the Department of
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(d) On at least a quarterly basis, the Department of
Human Resources shall make available on its public website all
of the following data from findings on noncompliance and fraud
investigations, provided the data is presented in the
aggregate and does not include confidential or personally
identifying information:
(1) The number of households investigated for
intentional program violations or fraud.
(2) The total number of households referred to the
Attorney General's office for prosecution.
(3) Improper payments and expenditures.
(4) Monies received.
(5) Aggregate data concerning improper payments and
ineligible recipients as a percentage of those investigated
and reviewed.
(6) The aggregate amount of funds expended by EBT
transactions in each state outside of Alabama.
(e) The Department of Human Resources shall adopt rules
to implement and administer this section.
Section 3. This act shall become effective on October
1, 2025.
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