AB 934 — Relating to: disenrollment of ineligible individuals from and redeterminations of eligibility for the Medical Assistance program and database confirmation for public assistance program eligibility. (FE)

-Date 2022of LEGISLATUREenactment: LRB-5789/1 TJD:amn ASSEMBLY BILL 934 January 31, 2022 - Introduced by Representatives ENTERMAN , AUGUST, VORPAGEL, A LLEN, BRANDTJEN , CABRAL-G UEVARA, CALLAHAN , DITTRICH, DMING , JAMES, K NODL, K UGLITSCH, L OUDENBECK , M ACCO, M AGNAFICI, M OSES, P ETERSEN, P LUMER , SCHRAA, SNYDER , SORTWELL , STEFFEN, TITTL, TUSLER, W ICHGERS, Z IMMERMAN and BORN , cosponsored by SenatorsTAFSHOLT , ACQUE, BERNIER, F EYEN and N ASS.

ReferredAssembly toBill Committee934 onDate Publicof Benefitpublication*: Reform.

WISCONSIN ACT A N A CT to renumber and amend 49.823;

and to create 49.45 (2) (a) 3m., 49.4549.471 (4d) and (4j) and 49.823 (2) of the statutes;

disenrollment of ineligible individuals from and redeterminations of eligibility for the MedicalMedi- cal Assistance program and database confirmation for public assistance program eligibility.

AnalysisThe bypeople of the Legislativestate Referenceof BureauWisconsin, Thisrepresented billin makesthe variousrecipient’s changes to eligibility determinations for publicbenefits assistanceshall programsbe and,ineligible specifically,senate theand Medicalassembly, Assistancedo program.enact as follows:

Thefor Medicalbenefits Assistanceunder programthis issection aor joints. federal and state program that provides health services to individuals who have limited financial resources.

The49.45 bill(23) prohibitsfor the6 Departmentmonths offollowing Healththe Servicesdate fromthat automatically renewing the eligibilitydepartment ofdiscovers aSECTION recipient1. for Medical Assistance program benefits.

DHS must determine an individual's eligibility every six months under the bill.

DHS is also prohibited from using prepopulated forms or otherwise supplying information, except for name and address, to a recipient of or an applicant for Medical Assistance that has been supplied to DHS.

Additionally, any recipient of Medical Assistance benefits that fails to timely report to DHS or its designee any change that may affect eligibility is ineligible for benefits for six months from the date DHS discovers the failure to report the change.

Under current law, knowingly concealing or failing to disclose any event that an individual knows affects the initial or continued right to a Medical Assistance benefit is subject to a forfeiture of not less than $100 nor more than $15,000 for each concealment or failure.

- 2022 Legislature - 2 - LRB-5789/1 TJD:amn ASSEMBLY BILL 934 The bill requires DHS to enter data sharing agreements with any agency that maintains a database of financial or personal information about residents of this state.

DHS must confirm the information of an applicant for a public assistance program against the information contained in those databases.

The bill also requires DHS to share data for this purpose of confirming eligibility for public assistance programs.

Current law requires DHS and the Department of Children and Families to compare each department's respective databases against the databases of death records to identify deceased participants.

The bill requires DHS to promptly remove from eligibility for the Medical Assistance program any individual who has been determined to be ineligible for the program.

Under the federal Families First Coronavirus Act, during a federally declared public health emergency, a state may receive an enhanced amount of federal financial participation in its Medical Assistance program if the state complies with certain criteria, including refraining from disenrolling individuals from the program.

Under the bill, if the disenrollment or any other part of the bill would cause the state not to comply, that portion of the bill that does not comply may not be implemented until the period of enhanced federal financial participation ends.

During the period before it ends, DHS must audit Medical Assistance eligibility and report quarterly to the legislature the number of individuals who are ineligible for Medical Assistance but who are receiving benefits.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

S ECTION 1.

of the statutes is created the failure to read:report the change.

to read:

Remove promptly from eligibility forS theECTION Medical3. Assistance program under this subchapter any individual who has been determined to be ineligible.

S49.823 ECTIONof 2.the statutes is renumbered for the Medical Assistance program under sub.

49.45(23) (4d)or ands. (4j) of the statutes are created to read:

49.4549.823 (4d)(1) Rand EDETERMINATIONamended OFto ELIGIBILITY.read:

The49.471 departmentany mayindividual notwho automaticallyhas renewbeen thedetermined eligibilityto ofbe a49.823(1) recipientThe department of Medicalhealth Assistanceservices benefitsand underthe thisineligible. subchapter.

The department shallof redeterminechildren eligibilityand forfamilies theshall, Medicalat Assistanceleast programonce underSECTION this2. subchapter for each individual every 6 months.

In49.471 collecting(4d) informationand from(4j) a recipient of Medicalthe Assistancestatutes benefitsare orevery an LRB-5789/1 - 2022 Legislature - 3 -months, TJD:amnperform SECTIONa 2comparison ASSEMBLYof BILLeach 934depart- applicant,ment’s therespective departmentpublic maybenefit notdatabase use any form that is prepopulated or otherwise provide to the recipient or applicant with information thatcreated has been supplied to theread: department except for the recipient's or applicant's name and address.

(4j)against FAILUREnationally TOrecognized REPORTAnydatabases recipient of Medical Assistance benefits under this subchapter who fails to timely report to the department or an entity designated by the department any change that maycontain affect49.471 the(4d) recipient'sR eligibilityEDETERMINATION forOF benefitsELIGIBILITY. shall be ineligible for benefits under this subchapter for 6 months following the date that the department discovers the failure to report the change.

SThe ECTIONdepartment 3.may not automatically renew the eligibility information on death records, including the federal social of a recipient of Medical Assistance benefits under this security administration’s Death Master File, to identify section or s.

49.82349.45 of(23). the statutes is renumbered 49.823 (1) and amended to read:

49.823 (1) The department ofshall healthredeter- services and the department of children and families shall, at least once every 3 months, perform a comparison of each department's respective public benefit database information against nationally recognized databases that contain information on death records, including the federal social security administration's Death Master File, to identify participants in public benefit programs that are deceased.

mine eligibility for the Medical Assistance program If a department determines during a review under this sectionunder subsectionthis thatsection aor participants. is deceased, the department shall designate that individual as ineligible for benefits in any applicable database.

The49.45 requirements(23) underfor thiseach sectionubsectionindividual dosection notsubsection applythat toa theparticipant departmentis ofdeceased, childrenthe anddepartment familiesshall withdesignate regardthat toindividual childas careineligible subsidiesevery under6 s.months.

In collecting information from a recipi- ent of Medical Assistance benefits or an applicant, the for benefits in any applicable database.

The require- department may not use any form that is prepopulated or ments under this section subsection do not apply to the otherwise provide to the recipient or applicant with infor- department of children and families with regard to child mation that has been supplied to the department except care subsidies under s.