Bill Text: IA SSB1131 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to public assistance program oversight.
Spectrum: Committee Bill
Status: (N/A - Dead) 2019-02-18 - Subcommittee recommends amendment and passage. [SSB1131 Detail]
Download: Iowa-2019-SSB1131-Introduced.html
Senate
Study
Bill
1131
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
LABOR
AND
BUSINESS
RELATIONS
BILL
BY
CHAIRPERSON
SCHULTZ)
A
BILL
FOR
An
Act
relating
to
public
assistance
program
oversight.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
TLSB
1957XC
(4)
88
pf/rh
S.F.
_____
Section
1.
PUBLIC
ASSISTANCE
PROGRAMS
——
VERIFICATION
OF
1
APPLICANT
ELIGIBILITY.
2
1.
The
department
of
human
services
shall
implement
an
3
eligibility
verification
system
for
public
assistance
programs
4
to
verify
the
eligibility
of
an
individual
who
is
an
applicant
5
for
any
such
program.
The
information
to
be
verified
and
6
sources
to
be
examined
for
each
individual
shall
include
but
7
are
not
limited
to
all
of
the
following:
8
a.
Earned
and
unearned
income.
9
b.
Employment
status
and
changes
in
employment.
10
c.
Immigration
status.
11
d.
Residency
status,
including
a
nationwide
best-address
12
source
to
verify
that
individuals
are
residents
of
the
state.
13
e.
Enrollment
status
in
other
state-administered
public
14
assistance
programs.
15
f.
Incarceration
status.
16
g.
Death
records.
17
h.
Enrollment
status
in
public
assistance
programs
outside
18
of
this
state.
19
i.
Records
of
any
potential
identity
fraud
or
identity
20
theft.
21
2.
The
department
of
human
services
shall
enter
into
a
22
memorandum
of
understanding
with
any
department,
division,
23
bureau,
section,
unit,
or
any
other
subunit
of
a
department,
as
24
necessary,
to
obtain
the
information
specified
in
subsection
1.
25
3.
The
department
may
contract
with
a
third-party
vendor
to
26
provide
the
information
specified
in
subsection
1.
Any
such
27
contract
shall
include
a
provision
that
ensures
that
annualized
28
savings
to
the
state
exceed
the
contract’s
total
annual
cost
29
to
the
state.
30
4.
Nothing
in
this
section
shall
preclude
the
department
31
of
human
services
from
receiving,
reviewing,
or
verifying
32
additional
information
related
to
the
eligibility
of
an
33
individual
not
specified
in
this
section
or
from
contracting
34
with
a
third-party
vendor
to
provide
additional
information
not
35
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1957XC
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8
S.F.
_____
specified
in
this
section.
1
5.
For
the
purposes
of
this
section,
“public
assistance
2
program”
shall
include
but
is
not
limited
to
the
Medicaid
3
program,
the
family
investment
program
(FIP),
and
the
4
supplemental
nutrition
assistance
program
(SNAP).
5
Sec.
2.
PUBLIC
ASSISTANCE
PROGRAMS
——
REAL-TIME
ELIGIBILITY
6
MONITORING.
7
1.
At
least
quarterly,
the
department
of
human
services
8
shall
obtain
and
review
all
of
the
following
information
and
9
sources
to
determine
ongoing
eligibility
of
an
enrollee
in
a
10
public
assistance
program:
11
a.
Earned
and
unearned
income.
12
b.
Employment
status
and
changes
in
employment.
13
c.
Residency
status.
14
d.
Enrollment
status
in
other
state-administered
public
15
assistance
programs.
16
e.
Financial
resources.
17
f.
Incarceration
status.
18
g.
Death
records.
19
h.
Lottery
winnings.
20
i.
Enrollment
status
in
public
assistance
programs
outside
21
of
the
state.
22
2.
The
department
of
human
services
shall
enter
into
a
23
memorandum
of
understanding
with
any
department,
division,
24
bureau,
section,
unit,
or
any
other
subunit
of
a
department
to
25
obtain
the
information
specified
in
subsection
1.
26
3.
The
department
may
contract
with
a
third-party
vendor
27
to
provide
the
information
specified
in
subsection
1.
Any
28
such
contract
shall
include
a
provision
that
ensures
that
any
29
annualized
savings
to
the
state
exceed
the
contract’s
total
30
annual
cost
to
the
state.
31
4.
The
department
shall
explore
opportunities
to
join
32
existing
multistate
collaborations
to
identify
individuals
who
33
are
also
enrolled
in
public
assistance
programs
outside
of
the
34
state,
including
the
national
accuracy
clearinghouse.
35
-2-
LSB
1957XC
(4)
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pf/rh
2/
8
S.F.
_____
5.
Nothing
in
this
section
shall
preclude
the
department
1
of
human
services
from
receiving
or
reviewing
additional
2
information
related
to
the
eligibility
of
an
individual
3
not
specified
in
this
section
or
from
contracting
with
a
4
third-party
vendor
to
provide
additional
information
not
5
specified
in
this
section.
6
6.
If
the
department
receives
information
about
an
enrollee
7
in
a
public
assistance
program
that
indicates
a
potential
8
change
or
discrepancy
in
circumstances
that
may
affect
the
9
individual’s
eligibility
for
that
public
assistance
program,
10
the
department
shall
review
the
individual’s
circumstances
and
11
respond
appropriately,
as
follows:
12
a.
If
the
review
does
not
result
in
the
department
13
confirming
any
discrepancy
or
change
in
an
individual’s
14
circumstances
that
may
affect
eligibility,
the
department
shall
15
take
no
further
action.
16
b.
If
the
review
results
in
the
department
finding
17
a
potential
discrepancy
or
change
in
the
individual’s
18
circumstances
that
may
affect
eligibility,
the
department
shall
19
promptly
notify
the
individual.
20
(1)
The
department
shall
provide
written
notice
to
the
21
enrollee,
which
shall
describe
in
sufficient
detail
the
22
circumstances
of
the
potential
discrepancy
or
change,
the
23
manner
in
which
the
enrollee
may
respond,
and
the
consequences
24
of
failing
to
take
action.
However,
a
self-declaration
of
an
25
enrollee
alone
shall
not
be
accepted
as
verification
to
refute
26
the
information.
27
(2)
The
enrollee
shall
have
ten
business
days,
or
the
28
minimum
required
by
federal
or
state
law,
to
respond
to
the
29
department
in
writing,
to
provide
information
to
refute
and
30
resolve
the
potential
discrepancy
or
change.
After
receiving
31
the
enrollee’s
written
response,
the
department
may
request
32
additional
documentation
if
the
department
determines
that
33
the
documentation
is
inadequate
or
that
a
risk
of
fraud
or
34
misrepresentation
exists.
A
self-declaration
of
an
enrollee
35
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_____
refuting
the
information
shall
not,
alone,
constitute
a
1
refutation
of
the
potential
discrepancy
or
change.
2
(3)
If
the
enrollee
does
not
respond
to
the
written
3
notice
in
a
timely
manner,
the
department
shall
provide
4
notice
to
terminate
the
individual’s
enrollment,
based
upon
5
the
individual’s
failure
to
cooperate,
and
shall
terminate
6
the
individual’s
enrollment
in
any
applicable
public
7
assistance
program.
The
individual’s
eligibility
shall
not
be
8
reestablished
until
the
discrepancy
or
change
is
resolved.
9
(4)
If
the
enrollee
responds
to
the
written
notice
in
a
10
timely
manner
and
disagrees
with
the
findings,
the
department
11
shall
reevaluate
the
enrollee’s
situation.
If
the
department
12
determines
through
the
reevaluation
that
the
information
upon
13
which
the
discrepancy
or
change
was
based
is
in
error,
the
14
department
shall
take
immediate
action
to
correct
the
error
and
15
no
further
action
on
the
enrollee’s
eligibility
status
shall
be
16
taken.
If
the
department
affirms
through
the
reevaluation
that
17
a
discrepancy
or
change
exists,
the
department
shall
determine
18
the
effect
on
the
enrollee’s
eligibility
and
take
appropriate
19
action.
Written
notice
of
the
results
of
the
department’s
20
reevaluation
and
the
actions
to
be
taken
shall
be
provided
to
21
the
individual.
22
(5)
If
the
enrollee
responds
to
the
written
notice
in
a
23
timely
manner
and
agrees
with
the
findings,
the
department
24
shall
determine
the
effect
on
the
enrollee’s
circumstances
and
25
take
appropriate
action.
Written
notice
of
the
actions
to
be
26
taken
by
the
department
shall
be
provided
to
the
individual.
27
7.
For
the
purposes
of
this
section,
“public
assistance
28
program”
shall
include
but
is
not
limited
to
Medicaid,
the
29
family
investment
program
(FIP),
and
the
supplemental
nutrition
30
assistance
program
(SNAP).
31
Sec.
3.
REPORTING
OF
FRAUD.
If,
through
the
department’s
32
activities
under
this
Act,
the
department
discovers
potential
33
fraudulent
activity,
the
department
shall
report
its
findings
34
and
any
supportive
information
to
the
office
of
the
attorney
35
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8
S.F.
_____
general
for
review.
1
Sec.
4.
ADMINISTRATION
——
REPORTING.
2
1.
The
department
of
human
services
shall
adopt
rules
3
pursuant
to
chapter
17A
to
administer
this
Act.
4
2.
The
department
shall
submit
a
report
to
the
governor
5
and
the
general
assembly
by
January
15,
2020,
and
by
January
6
15
annually
thereafter,
detailing
the
impact
of
verification
7
of
applicant
eligibility
for
public
assistance
programs
and
8
real-time
eligibility
monitoring
of
recipients
of
public
9
assistance
programs
as
provided
in
this
Act.
The
initial
10
report
shall
provide
information
for
the
period
beginning
July
11
1,
2019,
and
ending
December
31,
2019.
The
reports
shall
12
include
the
number
of
cases
reviewed,
the
number
of
cases
13
closed,
the
number
of
fraud
investigation
referrals
made,
and
14
the
amount
of
savings
and
cost
avoidance
realized
from
the
15
provisions
of
the
Act.
16
3.
The
department
of
human
services
shall
submit,
to
the
17
centers
for
Medicare
and
Medicaid
services
(CMS)
of
the
United
18
States
department
of
health
and
human
services
any
Medicaid
19
state
plan
amendment
or
waiver
request
necessary
to
administer
20
this
Act.
21
Sec.
5.
IMPLEMENTATION.
22
1.
The
provisions
of
this
Act
requiring
approval
of
a
23
Medicaid
state
plan
amendment
or
waiver
shall
be
implemented
24
upon
receipt
of
such
federal
approval.
25
2.
The
provisions
of
this
Act
not
requiring
approval
of
a
26
Medicaid
state
plan
amendment
or
waiver
shall
be
implemented
27
on
January
1,
2020.
28
EXPLANATION
29
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
30
the
explanation’s
substance
by
the
members
of
the
general
assembly.
31
This
bill
relates
to
public
assistance
program
oversight.
32
For
purposes
of
the
bill,
“public
assistance
program”
includes
33
but
is
not
limited
to
the
Medicaid
program,
the
family
34
investment
program,
and
the
supplemental
nutrition
assistance
35
-5-
LSB
1957XC
(4)
88
pf/rh
5/
8
S.F.
_____
program.
1
The
bill
provides
for
verification
of
a
public
assistance
2
program
applicant’s
eligibility.
The
department
of
human
3
services
(DHS)
is
required
to
implement
an
eligibility
4
verification
system
for
public
assistance
programs
to
verify
5
the
eligibility
of
an
individual
who
is
an
applicant
for
6
any
such
program.
The
bill
specifies
the
information
to
7
be
verified;
requires
DHS
to
enter
into
a
memorandum
of
8
understanding
with
any
department
or
subunit
of
a
department,
9
as
necessary,
to
obtain
the
information
specified;
and
10
authorizes
DHS
to
contract
with
a
third-party
vendor
to
11
provide
the
information
specified,
subject
to
a
provision
12
in
the
contract
that
ensures
that
annualized
savings
to
the
13
state
exceed
the
contract’s
total
annual
cost
to
the
state.
14
The
bill
does
not
preclude
DHS
from
receiving,
reviewing,
or
15
verifying
additional
information
related
to
the
eligibility
of
16
an
individual
not
specified
in
the
bill
or
from
contracting
17
with
a
third-party
vendor
to
provide
additional
information
not
18
specified
in
the
bill.
19
The
bill
provides
for
real-time
monitoring
of
the
20
eligibility
of
public
assistance
program
enrollees.
The
21
bill
requires
DHS,
as
least
quarterly,
to
obtain
and
review
22
specified
information
to
determine
ongoing
eligibility
of
23
an
individual
enrolled
in
a
public
assistance
program.
The
24
bill
requires
DHS
to
enter
into
memoranda
of
understanding
25
with
any
department
or
subunit
of
a
department,
as
necessary,
26
to
obtain
the
information
specified;
authorizes
DHS
to
27
contract
with
a
third-party
vendor
to
provide
the
information
28
specified,
subject
to
a
provision
in
the
contract
that
ensures
29
that
annualized
savings
to
the
state
exceed
the
contract’s
30
total
annual
cost
to
the
state;
and
requires
DHS
to
explore
31
opportunities
to
join
existing
multistate
collaborations
to
32
identify
individuals
who
are
also
enrolled
in
public
assistance
33
programs
outside
of
the
state,
including
the
national
accuracy
34
clearinghouse.
The
bill
does
not
preclude
DHS
from
receiving
35
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1957XC
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8
S.F.
_____
or
reviewing
additional
information
related
to
the
eligibility
1
of
an
individual
not
specified
in
the
bill
or
from
contracting
2
with
a
third-party
vendor
to
provide
additional
information
not
3
specified
in
the
bill.
4
The
bill
provides
that
if
DHS
receives
information
about
5
an
individual
enrolled
in
a
public
assistance
program
that
6
indicates
a
potential
change
or
discrepancy
in
circumstances
7
that
may
affect
the
enrollee’s
eligibility
for
that
8
public
assistance
program,
DHS
shall
review
the
enrollee’s
9
circumstances
and
respond
appropriately.
The
bill
delineates
10
the
appropriate
response
based
upon
the
response
of
the
11
enrollee
following
notice.
12
The
bill
provides
that
if,
through
the
department’s
13
activities
under
the
bill,
the
department
discovers
potential
14
fraudulent
activity,
the
department
shall
report
its
15
findings
and
any
supportive
information
to
the
office
of
the
16
attorney
general
for
review.
The
bill
requires
DHS
to
adopt
17
administrative
rules
to
administer
the
bill.
18
The
bill
requires
DHS
to
submit
a
report
to
the
governor
and
19
the
general
assembly
by
January
15,
2020,
and
by
January
15
20
annually
thereafter,
detailing
the
impact
of
the
provisions
of
21
the
bill
relating
to
verification
of
applicant
eligibility
for
22
public
assistance
programs
and
real-time
eligibility
monitoring
23
of
recipients
of
public
assistance
programs.
The
initial
24
report
must
include
information
for
the
period
beginning
July
25
1,
2019,
and
ending
December
31,
2019.
The
reports
shall
26
include
the
number
of
cases
reviewed,
the
number
of
cases
27
closed,
the
number
of
fraud
investigation
referrals
made,
and
28
the
amount
of
savings
and
cost
avoidance
resulting
from
the
29
provisions
of
the
bill.
30
The
bill
requires
DHS
to
submit,
to
the
centers
for
Medicare
31
and
Medicaid
services
of
the
United
States
department
of
health
32
and
human
services,
any
Medicaid
state
plan
amendment
or
waiver
33
request
necessary
to
administer
the
bill.
34
A
provision
of
the
bill
requiring
approval
of
a
Medicaid
35
-7-
LSB
1957XC
(4)
88
pf/rh
7/
8
