S.F. 334 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 26 vendor to provide any or all of the information specified 27 in subsection 1. Specifically, the department may contract 28 with a third-party consumer reporting agency, as defined by 29 the federal Fair Credit Reporting Act, 15 U.S.C. §1681a, for 30 the purpose of obtaining real-time employment and income 31 information as specified in subsection 1. Such contract shall 32 not require the third-party vendor to determine applicant 33 or enrollee eligibility. Any such contract shall include a 34 provision that ensures that annualized savings to the state 35 -1- SF 334 (5) 88 pf/rh/mb 1/ 6

S.F. 334 exceed the contract’s total annual cost to the state, and that 1 the cost of a third-party vendor to provide the information is 2 less than the cost to the department to internally obtain and 3 compile the information. 4 4. Nothing in this section shall preclude the department 5 of human services from receiving, reviewing, or verifying 6 additional information related to the eligibility of an 7 individual not specified in this section or from contracting 8 with a third-party vendor to provide additional information not 9 specified in this section. 10 5. For the purposes of this section, “public assistance 11 program” shall include but is not limited to the Medicaid 12 program, the family investment program (FIP), and the 13 supplemental nutrition assistance program (SNAP). 14 Sec. 2. PUBLIC ASSISTANCE PROGRAMS —— REAL-TIME ELIGIBILITY 15 MONITORING. 16 1. The department of human services shall implement a 17 real-time eligibility system that allows the department to 18 obtain and review all of the following information and sources 19 to determine ongoing eligibility of an enrollee in a public 20 assistance program: 21 a. Earned and unearned income. 22 b. Employment status and changes in employment. 23 c. Residency status. 24 d. Enrollment status in other state-administered public 25 assistance programs. 26 e. Financial resources. 27 f. Incarceration status. 28 g. Death records. 29 h. Lottery winnings. 30 i. Enrollment status in public assistance programs outside 31 of the state. 32 2. The department of human services shall enter into a 33 memorandum of understanding with any department, division, 34 bureau, section, unit, or any other subunit of a department to 35 -2- SF 334 (5) 88 pf/rh/mb 2/ 6

S.F. 334 obtain the information specified in subsection 1. 1 3. The department may contract with a third-party 2 vendor to provide any or all of the information specified 3 in subsection 1. Specifically, the department may contract 4 with a third-party consumer reporting agency, as defined by 5 the federal Fair Credit Reporting Act, 15 U.S.C. §1681a, for 6 the purpose of obtaining real-time employment and income 7 information as specified in subsection 1. Such contract shall 8 not require the third-party vendor to determine applicant 9 or enrollee eligibility. Any such contract shall include a 10 provision that ensures that annualized savings to the state 11 exceed the contract’s total annual cost to the state, and that 12 the cost of a third-party vendor to provide the information is 13 less than the cost to the department to internally obtain and 14 compile the information. 15 4. The department shall explore opportunities to join 16 existing multistate collaborations to identify individuals who 17 are also enrolled in public assistance programs outside of the 18 state, including the national accuracy clearinghouse. 19 5. Nothing in this section shall preclude the department 20 of human services from receiving or reviewing additional 21 information related to the eligibility of an individual 22 not specified in this section or from contracting with a 23 third-party vendor to provide additional information not 24 specified in this section. 25 6. If the department receives information about an enrollee 26 in a public assistance program that indicates a potential 27 change or discrepancy in circumstances that may affect the 28 individual’s eligibility for that public assistance program, 29 the department shall review the individual’s circumstances and 30 respond appropriately, as follows: 31 a. If the review does not result in the department 32 confirming any discrepancy or change in an individual’s 33 circumstances that may affect eligibility, the department shall 34 take no further action. 35 -3- SF 334 (5) 88 pf/rh/mb 3/ 6

S.F. 334 b. If the review results in the department finding 1 a potential discrepancy or change in the individual’s 2 circumstances that may affect eligibility, the department shall 3 promptly notify the individual. 4 (1) The department shall provide written notice to the 5 enrollee, which shall describe in sufficient detail the 6 circumstances of the potential discrepancy or change, the 7 manner in which the enrollee may respond, and the consequences 8 of failing to take action. However, a self-declaration of an 9 enrollee alone shall not be accepted as verification to refute 10 the information. 11 (2) The enrollee shall have thirty business days to respond 12 to the department in writing, to provide information to 13 refute and resolve the potential discrepancy or change. After 14 receiving the enrollee’s written response, the department may 15 request additional documentation if the department determines 16 that the documentation is inadequate or that a risk of fraud or 17 misrepresentation exists. A self-declaration of an enrollee 18 refuting the information shall not, alone, constitute a 19 refutation of the potential discrepancy or change. 20 (3) If the enrollee does not respond to the written 21 notice in a timely manner, the department shall provide 22 notice to terminate the individual’s enrollment, based upon 23 the individual’s failure to cooperate, and shall terminate 24 the individual’s enrollment in any applicable public 25 assistance program. The individual’s eligibility shall not be 26 reestablished until the discrepancy or change is resolved. 27 (4) If the enrollee responds to the written notice in a 28 timely manner and disagrees with the findings, the department 29 shall reevaluate the enrollee’s situation. If the department 30 determines through the reevaluation that the information upon 31 which the discrepancy or change was based is in error, the 32 department shall take immediate action to correct the error and 33 no further action on the enrollee’s eligibility status shall be 34 taken. If the department affirms through the reevaluation that 35 -4- SF 334 (5) 88 pf/rh/mb 4/ 6

S.F. 334 a discrepancy or change exists, the department shall determine 1 the effect on the enrollee’s eligibility and take appropriate 2 action. Written notice of the results of the department’s 3 reevaluation and the actions to be taken shall be provided to 4 the individual. 5 (5) If the enrollee responds to the written notice in a 6 timely manner and agrees with the findings, the department 7 shall determine the effect on the enrollee’s circumstances and 8 take appropriate action. Written notice of the actions to be 9 taken by the department shall be provided to the individual. 10 7. For the purposes of this section: 11 a. “Public assistance program” shall include but is not 12 limited to Medicaid, the family investment program (FIP), and 13 the supplemental nutrition assistance program (SNAP). 14 b. “Real-time eligibility system” means an electronic, 15 on-demand system that allows verification of all applicable 16 public assistance program eligibility information based on the 17 most recent information available to the department through 18 memoranda of understanding, contracts, or other necessary 19 agreements. 20 Sec. 3. REPORTING OF FRAUD. If, through the department’s 21 activities under this Act, the department discovers potential 22 fraudulent activity, the department shall report its findings 23 and any supportive information to the department of inspections 24 and appeals for review. 25 Sec. 4. ADMINISTRATION —— REPORTING. 26 1. The department of human services shall adopt rules 27 pursuant to chapter 17A to administer this Act. 28 2. The department shall submit a report to the governor 29 and the general assembly by January 15, 2022, and by January 30 15 annually thereafter, detailing the impact of verification 31 of applicant eligibility for public assistance programs and 32 real-time eligibility monitoring of recipients of public 33 assistance programs as provided in this Act. The reports shall 34 include the number of cases reviewed, the number of cases 35 -5- SF 334 (5) 88 pf/rh/mb 5/ 6

S.F. 334 closed, the number of fraud investigation referrals made, and 1 the amount of savings and cost avoidance realized from the 2 provisions of the Act. 3 3. The department of human services shall submit, to the 4 centers for Medicare and Medicaid services (CMS) of the United 5 States department of health and human services any Medicaid 6 state plan amendment or waiver request necessary to administer 7 this Act. 8 Sec. 5. IMPLEMENTATION. 9 1. The provisions of this Act requiring approval of a 10 Medicaid state plan amendment or waiver shall be implemented 11 upon receipt of such federal approval. 12 2. The provisions of this Act not requiring approval of a 13 Medicaid state plan amendment or waiver shall be implemented 14 on January 1, 2021. 15 -6- SF 334 (5) 88 pf/rh/mb 6/ 6