H.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 -1- LSB 5852YC (7) 87 pf/rh 1/ 10

H.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 5852YC (7) 87 pf/rh 2/ 10

H.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 -3- LSB 5852YC (7) 87 pf/rh 3/ 10

H.F. _____ 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. SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM —— 32 RESOURCE LIMITATIONS —— CHILD SUPPORT COOPERATION AS A 33 CONDITION OF ELIGIBILITY —— WORK REQUIREMENTS. 34 1. The department of human services shall not establish 35 -4- LSB 5852YC (7) 87 pf/rh 4/ 10

H.F. _____ resource limits for the supplemental nutrition assistance 1 program (SNAP) that exceed the resource limitations specified 2 in 7 U.S.C. §2014(g)(1), unless specifically required under 3 federal law. Additionally, categorical eligibility shall not 4 exempt households from these resource limits for any noncash, 5 in-kind, or other benefit, unless expressly required by federal 6 law. 7 2. The department of human services shall require, as a 8 condition of eligibility for SNAP, that an individual cooperate 9 with the child support recovery unit in establishing and 10 enforcing a child support order pursuant to 7 C.F.R. §273.11(o) 11 and (p). 12 3. a. The department of human services shall not seek, 13 apply for, accept, or renew any waiver of the work requirements 14 applicable to an individual to be eligible for SNAP pursuant to 15 7 U.S.C. §2015(o). 16 b. The department of human services shall assign an 17 individual who is subject to the work requirements specified 18 in 7 U.S.C. §2015(d)(1), but who is exempt from the work 19 requirements pursuant to 7 U.S.C. §2015(o), to participate in 20 an employment and training program established pursuant to 7 21 U.S.C. §2015(d)(4). 22 Sec. 4. WORK REQUIREMENTS —— MEDICAID PROGRAM. 23 1. The department of human services shall require that, 24 unless an individual is exempt pursuant to subsection 2, as a 25 condition of eligibility for Medicaid, a recipient shall do one 26 of the following: 27 a. Work twenty hours or more per week, averaged on a monthly 28 basis. 29 b. Participate in and comply with the requirements of a work 30 program for twenty hours or more per week, as determined by the 31 department. 32 c. Volunteer twenty hours or more per week, as determined 33 by the department. 34 d. Meet a combination of work and work program participation 35 -5- LSB 5852YC (7) 87 pf/rh 5/ 10

H.F. _____ requirements for a total of twenty hours or more per week, as 1 determined by the department. 2 e. Participate in and comply with the PROMISE JOBS program 3 pursuant to chapter 239B. 4 2. The following individuals shall be exempt from the 5 requirements specified in subsection 1: 6 a. An individual under the age of nineteen. 7 b. An individual over the age of sixty-four. 8 c. An individual medically certified as physically or 9 mentally unfit for employment. 10 d. An individual who is pregnant. 11 e. A parent or caretaker responsible for the care of a 12 dependent child under one year of age. 13 f. A parent or caretaker personally providing the care for a 14 dependent child with a serious medical condition or disability, 15 as determined by the department. 16 g. An individual receiving unemployment compensation and 17 complying with work requirements of the federal or state 18 unemployment compensation system. 19 h. An individual participating in a drug or alcohol 20 treatment and rehabilitation program. 21 Sec. 5. REPORTING OF FRAUD. If, through the department’s 22 activities under this Act, the department discovers potential 23 fraudulent activity, the department shall report its findings 24 and any supportive information to the office of the attorney 25 general for review. 26 Sec. 6. ADMINISTRATION —— REPORTING. 27 1. The department of human services shall adopt rules 28 pursuant to chapter 17A to administer this Act. 29 2. The department shall submit a report to the governor 30 and the general assembly by January 15, 2019, and by January 31 15 annually thereafter, detailing the impact of verification 32 of applicant eligibility for public assistance programs and 33 real-time eligibility monitoring of recipients of public 34 assistance programs as provided in this Act. The initial 35 -6- LSB 5852YC (7) 87 pf/rh 6/ 10

H.F. _____ report shall provide information for the period beginning July 1 1, 2018, and ending December 31, 2018. The reports shall 2 include the number of cases reviewed, the number of cases 3 closed, the number of fraud investigation referrals made, and 4 the amount of savings and cost avoidance realized from the 5 provisions of the Act. 6 3. The department of human services shall submit, to the 7 centers for Medicare and Medicaid services (CMS) of the United 8 States department of health and human services any Medicaid 9 state plan amendment or waiver request necessary to administer 10 this Act. 11 Sec. 7. IMPLEMENTATION. 12 1. The provisions of this Act requiring approval of a 13 Medicaid state plan amendment or waiver shall be implemented 14 upon receipt of such federal approval. 15 2. The provisions of this Act not requiring approval of a 16 Medicaid state plan amendment or waiver shall be implemented 17 on January 1, 2019. 18 EXPLANATION 19 The inclusion of this explanation does not constitute agreement with 20 the explanation’s substance by the members of the general assembly. 21 This bill relates to public assistance program oversight. 22 For purposes of the bill, “public assistance program” includes 23 but is not limited to the Medicaid program, the family 24 investment program (FIP), and the supplemental nutrition 25 assistance program (SNAP). 26 The bill provides for verification of a public assistance 27 program applicant’s eligibility. The department of human 28 services (DHS) is required to implement an eligibility 29 verification system for public assistance programs to verify 30 the eligibility of an individual who is an applicant for 31 any such program. The bill specifies the information to 32 be verified; requires DHS to enter into a memorandum of 33 understanding with any department or subunit of a department, 34 as necessary, to obtain the information specified; and 35 -7- LSB 5852YC (7) 87 pf/rh 7/ 10

H.F. _____ authorizes DHS to contract with a third-party vendor to 1 provide the information specified, subject to a provision 2 in the contract that ensures that annualized savings to the 3 state exceed the contract’s total annual cost to the state. 4 The bill does not preclude DHS from receiving, reviewing, or 5 verifying additional information related to the eligibility of 6 an individual not specified in the bill or from contracting 7 with a third-party vendor to provide additional information not 8 specified in the bill. 9 The bill provides for real-time monitoring of the 10 eligibility of public assistance program enrollees. The 11 bill requires DHS, as least quarterly, to obtain and review 12 specified information to determine ongoing eligibility of 13 an individual enrolled in a public assistance program. The 14 bill requires DHS to enter into memoranda of understanding 15 with any department or subunit of a department, as necessary, 16 to obtain the information specified; authorizes DHS to 17 contract with a third-party vendor to provide the information 18 specified, subject to a provision in the contract that ensures 19 that annualized savings to the state exceed the contract’s 20 total annual cost to the state; and requires DHS to explore 21 opportunities to join existing multistate collaborations to 22 identify individuals who are also enrolled in public assistance 23 programs outside of the state, including the national accuracy 24 clearinghouse. The bill does not preclude DHS from receiving 25 or reviewing additional information related to the eligibility 26 of an individual not specified in the bill or from contracting 27 with a third-party vendor to provide additional information not 28 specified in the bill. 29 The bill provides that if DHS receives information about 30 an individual enrolled in a public assistance program that 31 indicates a potential change or discrepancy in circumstances 32 that may affect the enrollee’s eligibility for that 33 public assistance program, DHS shall review the enrollee’s 34 circumstances and respond appropriately. The bill delineates 35 -8- LSB 5852YC (7) 87 pf/rh 8/ 10

H.F. _____ the appropriate response based upon the response of the 1 enrollee following notice. 2 The bill prohibits DHS from establishing resource limits 3 for the supplemental nutrition assistance program (SNAP) that 4 exceed the resource limitations specified in federal law, 5 unless specifically required under federal law. Additionally, 6 the bill provides that categorical eligibility shall not exempt 7 households from these resource limits for any noncash, in-kind, 8 or other benefit, unless expressly required by federal law. 9 The bill requires DHS to require, as a condition of 10 eligibility for SNAP, that an individual cooperate with the 11 child support recovery unit in establishing and enforcing a 12 child support order pursuant to federal law. 13 The bill also prohibits DHS from seeking, applying for, 14 accepting, or renewing any waiver of the work requirements 15 applicable to an individual to be eligible for SNAP, unless 16 the individual is exempt under federal law and requires DHS 17 to assign an individual who would otherwise be subject to the 18 work requirements under federal law, but meets the criteria for 19 one of the exemptions under federal law, to participate in an 20 employment and training program established as prescribed in 21 federal law. 22 The bill also requires DHS to require that, unless an 23 individual is exempt as specified in the bill, as a condition 24 of eligibility for Medicaid, a recipient shall work or 25 participate in a work program or a combination of both for 26 a certain number of hours, volunteer, or participate in the 27 PROMISE JOBS program. 28 The bill provides that if, through the department’s 29 activities under the bill, the department discovers potential 30 fraudulent activity, the department shall report its 31 findings and any supportive information to the office of the 32 attorney general for review. The bill requires DHS to adopt 33 administrative rules to administer the bill. 34 The bill requires DHS to submit a report to the governor and 35 -9- LSB 5852YC (7) 87 pf/rh 9/ 10

H.F. _____ the general assembly by January 15, 2019, and by January 15 1 annually thereafter, detailing the impact of the provisions of 2 the bill relating to verification of applicant eligibility for 3 public assistance programs and real-time eligibility monitoring 4 of recipients of public assistance programs. The initial 5 report must include information for the period beginning July 6 1, 2018, and ending December 31, 2018. The reports shall 7 include the number of cases reviewed, the number of cases 8 closed, the number of fraud investigation referrals made, and 9 the amount of savings and cost avoidance resulting from the 10 provisions of the bill. 11 The bill requires DHS to submit, to the centers for Medicare 12 and Medicaid services (CMS) of the United States department of 13 health and human services, any Medicaid state plan amendment or 14 waiver request necessary to administer the bill. 15 A provision of the bill requiring approval of a Medicaid 16 state plan amendment or waiver is to be implemented upon 17 receipt of such federal approval. A provision of the bill not 18 requiring approval of a Medicaid state plan amendment or waiver 19 is to be implemented on January 1, 2019. 20 -10- LSB 5852YC (7) 87 pf/rh 10/ 10