Relating to fraud prevention and verifying eligibility for benefits under Medicaid.
What changed between versions
Added new requirement for the Medicaid commission to conduct quarterly checks on Medicaid recipients' voter registration status to detect possible changes in residence.
Modified data matching requirements to include verification of lottery winnings and gambling winnings of $3,000 or more, and added death record matching to prevent benefits to deceased individuals.
Added new unlawful acts including failure to indicate the type of license held by a health care provider and failure to provide the provider's identification number when making claims.
Added new unlawful acts for managed care organizations including failure to provide required benefits, failure to provide required information, and engaging in fraudulent enrollment activities.
Added new unlawful acts for obstructing attorney general investigations and making false records related to state obligations under health care programs.
Added effective date of September 1, 2025, and provision allowing agencies to delay implementation if federal waivers are required.
Modified self-attestation requirements to require additional verification of income, residency, citizenship, age, household composition, and other criteria before enrolling individuals in medical assistance.
