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2016 Session

Budget Amendments - HB30 (Floor Approved)

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Improve Medicaid Eligibility Policy and Procedures (language only)

Item 310 #1h

Item 310 #1h

Health and Human Resources
Department of Medical Assistance Services

Language

Page 276, after line 54, insert:

"K.1. The Department of Medical Assistance Services shall require eligibility workers to apply the same protocols when verifying income for all individuals, including those who report no earned or unearned income at the earliest date feasible but no later than October 1, 2017.

2. The Department shall require eligibility workers to use available electronic data sources, including data from the Virginia Case Management System,  to search for unreported assets of deceased Medicaid recipients and to initiate recovery from estates for which the value of the assets is likely to exceed the cost of recovery.

3. The Department shall amend the Virginia Medicaid application, upon federal approval, to require Medicaid applicants to opt out if such applicant does not want to grant permission to the state to use his federal tax returns for the purposes of renewing eligibility.  The Department shall implement the necessary regulatory changes and other necessary measures to be consistent with federal approval of any appropriate state plan changes, and prior to the completion of any regulatory process undertaken in order to effect such change. "



Explanation

(This amendment requires Medicaid eligibility workers to implement several provisions to improve the current Medicaid eligibility policy and procedures based on a recent Joint Legislative Audit and Review Commission report on Medicaid eligibility determination. The Department of Medical Assistance Services (DMAS) shall require all Medicaid eligibility workers to apply the same protocols when verifying income for all applicants and recipients, including those who report no earned or unearned income, and use available electronic data sources to search for unreported assets of deceased Medicaid recipients and initiate recovery from estates for which the value is likely to exceed the cost of recovery. In addition, the bill requires DMAS to amend the Virginia Medicaid application, after obtaining approval from the federal Centers for Medicare and Medicaid Services, to allow a Medicaid applicant to opt out if such applicant does not want to grant permission to the state to use his federal tax returns for the purposes of renewing eligibility. Language allows the agency to implement emergency regulations to effect the changes.)