The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Christine Arbo Peck.
DIGEST
SB 7 Original 2018 First Extraordinary Session Walsworth
Proposed law presents legislative findings relative to fraud, waste, and abuse in the Medicaid
program, and concerning recommendations of the La. task force on coordination of Medicaid fraud
detection and prevention initiatives.
Proposed law provides that its purpose is to enhance the overall integrity of the La. Medicaid
program through necessary reforms to the program's eligibility determination functions.
Proposed law requires the La. Department of Health (LDH) to utilize state income tax return data
in the process of determining all of the following:
(1)A Medicaid applicant's initial eligibility for Medicaid benefits.
(2)A Medicaid enrollee's continued eligibility for Medicaid benefits at the time of his eligibility
redetermination.
Proposed law requires that LDH utilize state income tax return data including but not limited to
income and dependent information in its Medicaid eligibility determination process.
Proposed law requires the secretary of LDH to enter into any memorandum of understanding,
cooperative endeavor, or other type of agreement as may be necessary to facilitate mutual sharing
of data with the La. Department of Revenue for the purposes set forth in proposed law.
With respect to the income verification function of the Medicaid eligibility determination process,
proposed law requires LDH to ensure that the self-attested income of any applicant or enrollee
approved for initial or continuing Medicaid eligibility does not exceed his electronically reported
income by more than 10%.
Present law provides that the records and files of the secretary of the La. Department of Revenue are
confidential and privileged, and that no person shall divulge or disclose any information obtained
from such records and files except as authorized by present law.
Proposed law authorizes the secretary of the La. Department of Revenue to disclose individual-level
state income tax return data to the legislative auditor or the secretary of LDH for the following
purposes exclusively:
(1)Ensuring accuracy of Medicaid eligibility determinations.
(2)Detecting and preventing fraud in the Medicaid program. (3)Fulfilling the requirements of present law relative to Medicaid program integrity.
Proposed law authorizes the secretary of the La. Department of Revenue to enter into any
memorandum of understanding, cooperative endeavor, or other type of agreement as may be
necessary to facilitate sharing of data with the legislative auditor and the secretary of LDH,
respectively, for the purposes set forth in proposed law.
Present law provides for the powers and duties of the legislative auditor.
Proposed law retains present law and adds an authorization for the legislative auditor to access
individual-level state income tax return data, in accordance with proposed law, for the following
purposes:
(1)Ensuring accuracy of Medicaid eligibility determinations.
(2)Detecting and preventing fraud in the Medicaid program.
(3)Fulfilling all other applicable requirements of present law relative to Medicaid program
integrity.
Present law provides for the powers and duties of the secretary of LDH.
Proposed law retains present law and adds the following duties:
(1)To take such actions as are necessary to ensure accuracy in Medicaid eligibility
determinations.
(2)To work cooperatively with other state departments and officials, including but not limited
to the attorney general, the legislative auditor, and the La. Department of Revenue, in
detecting and preventing Medicaid fraud and fulfilling all other applicable requirements of
present law relative to Medicaid program integrity.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 24:513(P), R.S. 36:254(A)(6)(c) and (d), R.S. 46:440.9.1-440.9.4, and R.S.
47:1508(B)(42))