Bill Summary – FastDemocracy

Stricken language would be deleted from and underlined language would be added to present law.
                                           Act 780 of the Regular Session
 State of Arkansas              As Engrossed:      S3/15/21 S3/17/21
 93rd General Assembly                        A Bill
 Regular Session, 2021                                                             SENATE BILL 295
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 By: Senator Flippo
 By: Representative Lundstrum
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                                   For An Act To Be Entitled
                AN ACT TO PROMOTE INTEGRITY IN WELFARE PROGRAMS; TO
                AMEND THE MEDICAID ELIGIBILITY VERIFICATION SYSTEM;
                AND FOR OTHER PURPOSES.
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                                               Subtitle
                         TO PROMOTE INTEGRITY IN WELFARE PROGRAMS;
                         AND TO AMEND THE MEDICAID ELIGIBILITY
                         VERIFICATION SYSTEM.
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 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
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        SECTION 1.        DO NOT CODIFY.      Legislative findings.
        The General Assembly finds that:
                (1)      The State of Arkansas has lost millions of dollars to waste
 and fraud in its welfare programs;
                (2)      Inadequate eligibility verification policies have failed to
 maintain program integrity; and
                (3)      As demand for public assistance remains high due to economic
 uncertainties and closures related to the coronavirus 2019 (COVID-19)
 pandemic, protecting limited resources for the needy is critical.
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        SECTION 2.        Arkansas Code Title 20, Chapter 76, Subchapter 2, is
 amended to add an additional section to read as follows:
        20-76-215.        Program integrity in Supplemental Nutrition Assistance
 Program.
        (a)    Except when prohibited by federal law, the Department of Human
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     As Engrossed:    S3/15/21 S3/17/21                                           SB295
 Services shall adopt the following procedures to verify eligibility for
 participation in the Supplemental Nutrition Assistance Program or for receipt
 of Supplemental Nutrition Assistance Program benefits:
            (1)     All conditions of eligibility for assistance shall be
 verified before authorization of assistance and during a recertification of a
 recipient's eligibility; and
            (2)(A)     Except when prohibited by federal law, it is a condition
 of eligibility for assistance that an applicant or recipient consents to the
 disclosure of information about the age, residence, citizenship, employment,
 application for employment, income, and resources of the applicant or
 recipient that are in the possession of a third party.
                     (B)   The consent of the applicant or recipient is effective
 to empower any third party to release information requested by the Department
 of Human Services.
      (b)(1)(A)     The Department of Human Services shall enter into a data
 matching agreement with the Office of the Arkansas Lottery, Arkansas Racing
 Commission, and all other commissions and agencies with relevant information
 to identify individuals with lottery or gambling winnings.
                     (B)   Data received under a data matching agreement
 described in subdivision (b)(1)(A) of this section shall be treated as
 verified upon receipt.
            (2)(A)     On at least a monthly basis, the Department of Human
 Services shall review the information described in subdivision (b)(1) of this
 section and deny or revoke assistance for the entire household upon
 verification of any substantial winnings exceeding the resource limits for
 that household or the threshold set under 7 C.F.R. 272.17, as existing on
 January 1, 2021.
                     (B)   If the Department of Human Services discovers,
 including through a database match, that a household fails to disclose
 substantial winnings that would result in being ineligible for the
 Supplemental Nutrition Assistance Program, the household shall be referred to
 the Office of Appeals and Hearings of the Department of Human Services to
 determine whether an intentional program violation has occurred through a due
 process hearing.
      (c)   The Department of Human Services shall review information:
            (1)     From the Department of Health concerning individuals
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 enrolled in assistance that indicates a change in circumstances, including
 without limitation death certificates, that may affect eligibility, on at
 least a monthly basis;
            (2)    From the Division of Workforce Services, the Department of
 Finance and Administration, the United States Department of Health and Human
 Services, the Office of Child Support Enforcement, and the National Directory
 of New Hires concerning individuals enrolled in assistance that indicates a
 change in circumstances that may affect eligibility, including without
 limitation a change in employment or wages, on at least a quarterly basis;
            (3)    From the Division of Workforce Services concerning
 individuals enrolled in assistance that indicates a change in circumstances
 that may affect eligibility, including without limitation a change in
 employment or wages;
            (4)    Concerning individuals enrolled in assistance that indicates
 a change in circumstances that may affect eligibility, including without
 limitation potential changes in residency as identified by out-of-state
 electronic benefit transfer transactions, on at least a monthly basis; and
            (5)    From the Department of Corrections and the Division of
 Correction concerning individuals enrolled in assistance that indicates a
 change in circumstances that may affect eligibility.
      (d)   On at least an annual basis, the Department of Human Services
 shall make available to the public on its website data, including without
 limitation information regarding noncompliance and fraud investigations in
 assistance for the following aggregate and nonconfidential and nonpersonally
 identifying information:
            (1)    The number of assistance cases investigated for intentional
 program violations or fraud;
            (2)    The total number of assistance cases referred for
 prosecution;
            (3)    Improper payments and expenditures;
            (4)    Monies recovered;
            (5)    Aggregate data concerning improper payments and ineligible
 recipients as a percentage of those investigated and reviewed; and
            (6)    Aggregate amount of funds expended by electronic benefits
 transfer card transactions in each state outside of Arkansas.
      (e)   If the Department of Human Services receives information
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 concerning an individual or household enrolled in assistance that indicates a
 change in circumstances that may affect eligibility, the Department of Human
 Services shall review the individual's or household's case.
      (f)     The Department of Human Services may execute a memorandum of
 understanding with any other state department, agency, or division for
 information required to be shared between agencies under this section.
      (g)(1)     Notwithstanding other provisions of law, a household receiving
 assistance shall be subject to change reporting and report changes in
 circumstances, established by 7 C.F.R.  273.12(a)(1), as it existed on
 January 1, 2021, within ten (10) days of the date the change becomes known to
 the household unless the household is designated as a simplified reporting
 household.
               (2)(A)     A household that is designated as a simplified reporting
 household shall be assigned a certification period of six (6) months or less.
                        (B)   The Department of Human Services shall begin phasing
 in the reduction in certification periods for simplified reporting households
 no later than September 1, 2022.
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      SECTION 3.        Arkansas Code  20-77-2102 is amended to read as follows:
      20-77-2102.        Medicaid Eligibility Verification System  Definitions.
      (a)     The Department of Human Services shall establish and maintain the
 Medicaid Eligibility Verification System that is designed to prevent fraud in
 the establishment and maintenance of Medicaid eligibility.
      (b)(1)     In establishing the Medicaid Eligibility Verification System,
 the department shall have the flexibility to determine whether the state
 shall be an assessment state or and not a determination state for
 purposes of Medicaid eligibility determinations by the federally facilitated
 marketplace.
               (2)    As used in this subsection:
                        (A)   Assessment state means a state with a federally
 facilitated marketplace that can elect to have the federally facilitated
 marketplace make assessments of Medicaid eligibility and then transfer the
 account of an individual to the state Medicaid agency for a final
 determination; and
                        (B)   Determination state means a state that requires the
 eligibility determination made by the federally facilitated marketplace to be
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 accepted by the state Medicaid agency.
      (c)   Notwithstanding other provisions of law, the department shall not
 accept Medicaid eligibility determinations from an exchange or marketplace
 established under 42 U.S.C.  18041(c) before verifying eligibility
 independently and making a Medicaid eligibility determination.
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      SECTION 4.        Arkansas Code Title 20, Chapter 77, Subchapter 21, is
 amended to add additional sections to read as follows:
      20-77-2104.        Medicaid eligibility verification.
      (a)   Except when prohibited by federal law, the Department of Human
 Services shall adopt the following procedures to verify Medicaid eligibility
 for participation in the Arkansas Medicaid Program or receipt of benefits in
 the Arkansas Medicaid Program:
               (1)    All conditions of eligibility for Medicaid assistance shall
 be verified before authorization of Medicaid assistance and during a
 reevaluation of a recipients eligibility; and
               (2)(A)     Except when prohibited by federal law, a condition of
 eligibility for assistance is that an applicant or recipient consents to the
 disclosure of information about the age, residence, citizenship, employment,
 applications for employment, income, and resources of the applicant or
 recipient that are in the possession of third parties.
                        (B)   The consent described in subdivision (a)(2)(A) of this
 section shall be effective to empower any third party to release information
 requested by the Department of Human Services.
      (b)(1)     The Department of Human Services shall enter into a data
 matching agreement with the Office of the Arkansas Lottery and the Arkansas
 Racing Commission to identify individuals with substantial winnings.
               (2)    On at least a quarterly basis, the Department of Human
 Services shall review this information and act on any changes that may affect
 eligibility consistent with 42 U.S.C. 1396, as existing on January 1, 2021.
      (c)   The Department of Human Services shall review information:
               (1)    From the Department of Health concerning individuals
 enrolled in Medicaid assistance that indicates a change in circumstances,
 including without limitation death certificates, that may affect eligibility,
 on at least a monthly basis;
               (2)    From the Division of Workforce Services and the Department
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 of Finance and Administration concerning individuals enrolled in assistance
 that indicates a change in circumstances that may affect eligibility,
 including without limitation a change in employment or wages, on at least a
 quarterly basis;
            (3)     Concerning individuals enrolled in assistance that indicates
 a change in circumstances that may affect eligibility, including without
 limitation potential changes in residency as identified by out-of-state
 electronic benefit transfer transactions, on at least a monthly basis; and
            (4)     From the Department of Corrections and the Division of
 Correction concerning individuals enrolled in Medicaid assistance that
 indicates a change in circumstances that may affect eligibility.
      (d)   Annually, the Department of Human Services shall make available to
 the public on its website data, including without limitation information
 regarding noncompliance and fraud investigations in assistance for the
 following aggregate and nonconfidential and nonpersonally identifying
 information:
            (1)     The number of assistance cases investigated for intentional
 Arkansas Medicaid Program violations or fraud;
            (2)     The total number of assistance cases referred for
 prosecution;
            (3)     Improper payments and expenditures;
            (4)     Monies recovered; and
            (5)     Aggregate data concerning improper payments and ineligible
 recipients as a percentage of those investigated and reviewed.
      (e)   If the Department of Human Services receives information
 concerning an individual enrolled in Medicaid assistance that indicates a
 change in circumstances that may affect eligibility, the Department of Human
 Services shall review the individual's or household's case.
      (f)   The Department of Human Services may execute a memorandum of
 understanding with any other state department, agency, or division for
 information required to be shared between agencies under this section.
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      20-77-2105.     Additional program integrity measures.
      (a)   Unless required under federal law, the Department of Human
 Services shall not:
            (1)     Designate itself as a qualified health entity for the
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 purpose of making presumptive eligibility determinations or for any purpose
 not expressly authorized by state law;
            (2)    Accept self-attestation of income, residency, age, household
 composition, caretaker or relative status, or receipt of other coverage
 without verification before enrollment; or
            (3)    Request authority to waive or decline to periodically check
 any available income-related data sources to verify eligibility.
      (b)   When the department receives funding for Medicaid contingent on
 temporary maintenance of effort restrictions or, for any reason, is limited
 in the department's ability to unenroll individuals, such as restrictions
 imposed by Section 6008 of the Families First Coronavirus Response Act, Pub.
 L. No. 116-127, the department shall:
            (1)    Within one hundred eighty (180) days of the expiration of
 the restrictions, complete a full audit in which the department shall:
                    (A)   Complete and act on eligibility reevaluations for all
 cases that have not had a reevaluation within the last twelve (12) months;
                    (B)   Carry out an additional check of all verification
 measures required in this subchapter to verify eligibility and act on the
 information checked; and
                    (C)   Submit a summary report of the audit to the President
 Pro Tempore of the Senate and Speaker of the House of Representatives; and
            (2)    Continue to conduct reevaluations as in the normal course of
 business and act on such reevaluations to the fullest extent permissible
 under the law.
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      SECTION 5.    Arkansas Code Title 23, Chapter 115, Subchapter 1, is
 amended to add an additional section to read as follows:
      23-115-105.    Data sharing with Department of Human Services.
      The Office of the Arkansas Lottery and the Arkansas Racing Commission
 shall enter into a data matching agreement with the Department of Human
 Services for purposes under  20-76-215 and 20-77-2104.
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      SECTION 6.    Arkansas Code  26-18-303(b), concerning confidential and
 privileged records and exceptions, is amended to add an additional
 subdivision to read as follows:
            (26)    Disclosure to the Department of Human Services as required
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 by  20-76-215(c) or  20-77-2104(c) to determine whether a change in
 circumstances has occurred that would affect the eligibility of an applicant
 for benefits unde