§ 12-15-1-24 — Prohibition on self-attestation without verification; data matching agreements; review of data from other agencies concerning Medicaid recipients

Indiana § 12-15-1-24

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 1: Administration

Text

(a) Except as required under federal law, the
office of the secretary may not accept self-attestation of any of the
following in the administration of the Medicaid program without
verification before enrollment:
(1) Income.
(2) Residency.
(3) Age.
(4) Household composition.
(5) Caretaker or relative status.
(6) Receipt of other coverage.
(b) The office of the secretary shall enter into a data matching
agreement with:
(1) the state lottery commission; and
(2) the Indiana gaming commission;
to, on at least a monthly basis, identify individuals receiving Medicaid
assistance with lottery and gambling winnings of at least three
thousand dollars ($3,000). Upon verification of any winnings resulting
in the individual no longer being eligible for Medicaid, the office of the
secretary shall terminate the individual's enrollment.
(c) On at least a monthly basis, the office of the secretary shall
review vital statistics information provided by the Indiana department
of health under IC 16-19-3-19 to determine removal of deceased
individuals from Medicaid enrollment.
(d) On at least a quarterly basis, the office of the secretary shall
receive and review information from the department of state revenue
and the department of workforce development concerning Medicaid
recipients that indicates a change in circumstances that may affect
eligibility, including changes to employment or wages.
(e) On at least an annual basis, the office of the secretary shall
receive and review information from the department of state revenue
concerning Medicaid recipients, including:
(1) adjusted gross income; and
(2) family composition;
that indicates a change in circumstances that may affect Medicaid
eligibility.
(f) On at least a monthly basis, the office of the secretary shall
review information concerning Medicaid recipients who also receive
SNAP to determine whether there has been any change in
circumstances that may affect Medicaid eligibility, including a change
in residency as may be identified through electronic benefit transfer
program transactions.
(g) On at least a monthly basis, the office of the secretary shall
receive and review information from the department of correction
concerning Medicaid recipients that may indicate a change in
circumstances that may affect Medicaid eligibility.
(h) Upon receiving information concerning a Medicaid recipient
that indicates a change in circumstances that may affect Medicaid
eligibility, the office of the secretary shall promptly conduct an
eligibility redetermination for the recipient.

Legislative History

As added by P.L.126-2025, SEC.5.