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 -1- LSB 1957XC (4) 88 pf/rh 1/ 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) 88 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 -3- LSB 1957XC (4) 88 pf/rh 3/ 8

S.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. 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 -4- LSB 1957XC (4) 88 pf/rh 4/ 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 -6- LSB 1957XC (4) 88 pf/rh 6/ 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