SB 130: MEDICAID: Provides relative to Medicaid. (gov sig) (EN DECREASE GF EX See Note) - Louisiana

Senate Floor Bureau Note, #2011, Cloud, Adopted → SB130 Act 427 · 6 edits

MODERATE

This bill enacts new Medicaid program integrity measures to prevent fraud and waste by requiring the state to use real-time data matching and automated verification systems. It mandates regular cross-checks with state agencies for vital records, employment, residency, and tax data to verify recipient eligibility. The law also restricts reliance on ex parte renewals and requires the publication of non-personal fraud investigation statistics.

Scope change

The bill expands the scope of Medicaid oversight by introducing mandatory interagency data sharing and specific verification protocols that were not previously codified in this manner.

REQUIREMENT

Mandates monthly, quarterly, and semi-annual data matching agreements with state agencies (vital records, workforce commission, motor vehicles, revenue, incarceration status, and Social Security Administration) to verify Medicaid eligibility.

Prohibits the Department of Health from relying solely on ex parte renewals for eligibility determinations unless required by federal law.

Requires the Department of Health to withdraw any existing waivers authorizing ex parte renewals by January 1, 2026.

Prohibits accepting self-attestation for residency and mandates the use of technology and data sharing to verify income, residency, and household composition.

Authorizes the procurement of an enhanced income verification platform using automated, real-time data matching to detect unreported income.

ENFORCEMENT

Requires the Department of Health to publish quarterly, non-personal statistics on Medicaid fraud and noncompliance investigations on its website.

SB130 Original → Senate Floor Bureau Note, #2011, Cloud, Adopted · 2 edits

MINOR

The bill was amended to update the specific statute citation numbers from 440.17 to 440.21 throughout the text. Additionally, a new requirement was added mandating that the Department of Health publish data regarding findings of program integrity measures on its website. These changes clarify the legal reference and increase transparency by requiring public reporting of audit results.

Scope change

The bill's scope remains focused on Medicaid program integrity, but the specific legal citation for the new section was updated to reflect a different statute number.

TECHNICAL

Updated all references to the new statute section from R.S. 46:440.17 to R.S. 46:440.21 and from section 440.17 to 440.21.

ENFORCEMENT

Added a requirement for the Department of Health to publish data regarding findings of program integrity measures on its website.

SB130 Enrolled → SB130 Original · 10 edits

MAJOR

This bill amends the Medicaid program integrity measures by shifting the statutory citation from R.S. 46:440.21 to R.S. 46:440.17. The substantive changes strengthen eligibility verification by requiring the Department of Health to use real-time data matching, consumer-permissioned bank transaction access, and specific cross-checks with vital records, workforce data, and incarceration status. It also tightens restrictions on 'ex parte' renewals, mandating the department withdraw any federal waivers allowing such renewals by January 1, 2026, and prohibits the use of self-attestation for income, residency, or age without prior verification.

Scope change

The bill modifies the specific section of the Louisiana Revised Statutes governing Medicaid program integrity measures, expanding the scope of required data verification and cross-checking mechanisms.

REQUIREMENT

The statutory citation for Medicaid program integrity measures was changed from R.S. 46:440.21 to R.S. 46:440.17.

Added a requirement for the Department of Health to use an enhanced income verification platform that incorporates consumer-permissioned access to bank transactions to verify income sources.

Added a requirement to cross-check Medicaid households with the Department of Children and Family Services to identify changes in residency via out-of-state EBT transactions.

Added a requirement to receive and review information from the Department of Public Safety and Corrections regarding changes in incarceration status.

Added a requirement to receive and review information from the Louisiana Workforce Commission on a semi-monthly basis regarding employment or wage changes.

ELIGIBILITY

Changed the frequency of data reviews from quarterly to monthly for the Department of Public Safety and Corrections regarding incarceration status.

Changed the frequency of data reviews from quarterly to semi-monthly for the Louisiana Workforce Commission regarding employment or wage changes.

Removed the allowance for accepting eligibility determinations from federal health exchanges without independent verification.

Expanded the list of attributes for which self-attestation is prohibited to include income, residency, age, household composition, caretaker status, and receipt of other coverage.

TIMELINE

Added a mandate for the Department of Health to withdraw any federal waivers authorizing ex parte renewals by January 1, 2026.

SB130 Reengrossed → SB130 Enrolled · 5 edits · Jun 20, 2025

MODERATE

The bill was finalized as an Enrolled version, changing the header from 'Reengrossed' to 'Enrolled' and updating the page count from 5 to 4. Substantively, the bill's purpose was slightly refined to focus on 'eligibility determinations' rather than 'program integrity measures' in the opening summary. The core policy content regarding Medicaid data cross-checks, the ban on self-attestation for residency, and the requirement to withdraw ex parte renewal waivers by January 1, 2026, remains unchanged.

Scope change

The bill's scope remains focused on Medicaid eligibility verification and fraud prevention; no new populations or funding levels were added or removed.

TECHNICAL

The document header was updated from 'Reengrossed' to 'Enrolled' and the page count was reduced from 5 to 4, indicating the final version of the bill.

SCOPE

The introductory summary of the bill was slightly reworded to emphasize 'Medicaid eligibility determinations' instead of 'program integrity measures' as the primary focus.

ELIGIBILITY

The requirement for the Department of Health to stop accepting self-attestation for Louisiana residency and use data sharing to verify income and residency remains in effect.

TIMELINE

The deadline to withdraw federal waivers allowing 'ex parte renewals' (eligibility renewals without full review) remains set for January 1, 2026.

REQUIREMENT

All requirements for monthly, quarterly, and semi-annual data cross-checks with state agencies (Vital Records, Workforce Commission, DPS, Revenue) and the Social Security Administration remain identical.

SB130 Engrossed → SB130 Reengrossed · 3 edits · Jun 9, 2025

MINOR

The bill was reengrossed to correct a statutory citation error, changing the referenced law from R.S. 46:440.17 to R.S. 46:440.21. Additionally, the review frequency for Medicaid incarceration data was reduced from quarterly to annually, and public reporting requirements were expanded to include specific data on noncompliance and fraud findings.

Scope change

The bill's scope was technically adjusted by correcting the specific statute number it amends, ensuring the legislation targets the correct legal provision.

TECHNICAL

Corrected the statutory citation from R.S. 46:440.17 to R.S. 46:440.21 throughout the document.

REQUIREMENT

Changed the requirement for reviewing Medicaid incarceration status information from a quarterly basis to an annual basis.

ENFORCEMENT

Modified public reporting requirements to explicitly include data on noncompliance and fraud investigations.

MEDICAID: Provides relative to Medicaid. (gov sig) (EN DECREASE GF EX See Note)

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