BILL NUMBER: S9460
SPONSOR: WEBB
TITLE OF BILL:
An act to amend the social services law, in relation to obtaining
certain employment and income data of individuals eligible for medical
assistance
PURPOSE:
Allows the Department of Health to utilize current income and employment
verification information from a third-party to ensure Medicaid eligible
individuals are promptly enrolled and able to receive services.
SUMMARY OF PROVISIONS:
Section 1 authorizes the Commissioner of Health to obtain current income
and employment verification information through a third-party commercial
consumer reporting agency to improve decision timeliness, achieve cost
savings, and ensure prompt provision of services through the State's
Medicaid program.
Section 2 sets forth the effective date.
EXISTING LAW:
Current law requires an individual applying for Medicaid to provide
documentation of wages received by all employed family members who are
included in the application and by all legally responsible relatives
living with the applicant. Acceptable forms of documentation are pay
envelopes, wage stubs, or an employer's statement of wages. If the
applicant's income varies, the documentation must show all wages earned
in the past four weeks.
JUSTIFICATION:
New York currently utilizes IRS and quarterly wage data to help deter-
mine an individual's eligibility for the Medicaid program. Unlike the
majority of states across the nation, New York does not take advantage
of the most recent data sources available to verify income and employ-
ment, and the information that is used is often stale at the time an
individual applies for benefits.
The Affordable Care Act (ACA) and accompanying federal regulations
established a data-driven approach to verify financial and non-financial
information needed to determine Medicaid eligibility. This led to the
creation of the CMS Federal Data Services Hub - commonly referred to as
the "CMS Hub." The CMS Hub provides states with the most recent employ-
ment and income data available, and there are reimbursement opportu-
nities provided by the federal government for states that access this
information.
In light of the uncertainty surrounding Medicaid at the federal level,
New York should consider accessing information that is potentially
current as of the last pay period, rather than outdated data. Updating
the process for income and employment verifications can free-up
resources and improve timeliness of determinations, thus greatly bene-
fiting program enrollees.
LEGISLATIVE HISTORY:
New bill
FISCAL IMPLICATIONS:
To be determined
LOCAL FISCAL IMPLICATIONS:
To be determined
EFFECTIVE DATE:
This act shall take effect immediately
Statutes affected: S9460: 366 social services law