S. 1082 — Safeguarding Medicaid Act

This section expands the Medicaid asset verification program—under which states verify applicants' self-declared assets electronically (i.e., through federal databases such as the IRS and financial institution data)—to all applicants for and recipients of medical assistance in all states and territories by (1) striking the limitation in subsection (b)(1)(A) to individuals eligible on the basis of being aged, blind, or disabled and (2) striking paragraph (4) of subsection (a). The Secretary of Health and Human Services must promulgate implementing rules. The amendments take effect one year after enactment, during which states must submit and implement plans for an electronic integrated asset verification program (with states permitted to implement early or request a delay of up to 365 days based on economic hardship, as determined by the state's chief executive officer).

This section requires states, effective two years after enactment, to apply a resources eligibility test—precluding Medicaid eligibility for individuals whose resources (as determined under SSI rules) exceed the SSI maximum ($2,000 for an individual or $3,000 for a couple, or a state-established amount)—for any applicant subject to an income eligibility determination under the state plan or waiver, except as to continuous eligibility periods for pregnant or postpartum women or children under age 19. (As background, certain Medicaid eligibility groups, such as the ACA expansion population using modified adjusted gross income methodology, currently disregard resources.) The section also makes conforming amendments to child continuous eligibility provisions to reference resources in addition to income.

This section requires the Centers for Medicare & Medicaid Services (CMS) to (1) create, not later than two years after enactment, a federal tracking system for savings in federal Medicaid expenditures (under title XIX of the Social Security Act) associated with the asset verification program; (2) require states, beginning with the first year after enactment and as part of the triennial review under the Payment Error Rate Measurement (PERM) program, to submit publicly available reports on eligibility determinations and renewals—including the number of renewals initiated and asset checks conducted, beneficiaries renewed on a total and ex parte basis, asset checks out of new applications and eligible applicants thereafter, and other information specified by the Secretary (with regulations modifying requirements for Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa to be similar but reasonable); and (3) assess state compliance with federal eligibility determination, redetermination, and PERM reporting requirements and, for noncompliance during the preceding 180 days, require states to submit a corrective action plan within 90 days, receive approval or disapproval within 90 days thereafter, and implement it within 90 days of approval.