§ 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 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.

Legislative History

Added by Act 2021, No. 780,§ 4, eff. 7/28/2021.