S2954-118

1. Short title This Act may be cited as the Protecting Medicaid Beneficiaries Act of 2023 .

2. Application of medicaid asset test to all applicants for, and recipients of, medical assistance in all States and territories Section 1940 of the Social Security Act (42 U.S.C. 1396w) is amended— in subsection (a), by striking paragraph (4); and in subsection (b)(1)(A), by striking on the basis of being aged, blind, or disabled. The Secretary of Health and Human Services shall promulgate such rules as are necessary to implement the amendments made by subsection (a). Subject to paragraph (2), the amendments made by subsection (a) shall take effect on the date that is 1 year after the date of enactment of this Act. During the 1-year period that begins on the date of enactment of this Act, the Secretary of Health and Human Services shall require States to submit and implement a plan for an electronic integrated asset verification program that meets the requirements of section 1940 of the Social Security Act (as amended by subsection (a)). Nothing in this subsection or section 1940 of the Social Security Act (42 U.S.C. 1396w) shall be construed as prohibiting a State from implementing an asset verification program that meets the requirements of such section (as amended by subsection (a)) in advance of the effective date specified under paragraph (1). If a State requests a delay of the effective date specified under paragraph (1) on the basis of ongoing economic hardship limitations, as determined by the chief executive officer of the State, the Secretary of Health and Human Services may delay such effective date for up to 365 days.

3. Medicaid resources eligibility requirement Section 1902(e)(14)(C) of the Social Security Act (42 U.S.C. 1396a(e)(14)(C)) is amended to read as follows: Except as provided in clause (iii), notwithstanding any other provision of this title, in the case of an individual with respect to whom a determination of income eligibility for medical assistance under the State plan or under any waiver of such plan is required, the State shall also apply a resources eligibility test that meets the requirement of clause (ii). A State resources eligibility test meets the requirement of this clause if the test precludes eligibility for any individual whose resources (as determined under section 1613 for purposes of the supplemental security income program) exceed the maximum amount of resources that an individual may have and obtain benefits under that program, or such amount as the State shall establish. Nothing in this subparagraph shall affect the application of paragraph (6), (12), or (16) of this subsection (relating to continuous eligibility for pregnant and postpartum women and children under the age of 19). Section 1902(e)(6) of the Social Security Act (42 U.S.C. 1396a(e)(6)) is amended by inserting or resources after income each place it appears. The amendments made by this section shall take effect on the date that is 2 years after the date of enactment of this Act. (C)Resources test requirement(i)In generalExcept as provided in clause (iii), notwithstanding any other provision of this title, in the case of an individual with respect to whom a determination of income eligibility for medical assistance under the State plan or under any waiver of such plan is required, the State shall also apply a resources eligibility test that meets the requirement of clause (ii).(ii)RequirementA State resources eligibility test meets the requirement of this clause if the test precludes eligibility for any individual whose resources (as determined under section 1613 for purposes of the supplemental security income program) exceed the maximum amount of resources that an individual may have and obtain benefits under that program, or such amount as the State shall establish.(iii)No effect on continuous eligibility requirements for pregnant and postpartum women or childrenNothing in this subparagraph shall affect the application of paragraph (6), (12), or (16) of this subsection (relating to continuous eligibility for pregnant and postpartum women and children under the age of 19)..

4. Requiring CMS to track State asset verification of Federal Medicaid programs Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the Centers for Medicare & Medicaid Services, shall create a Federal tracking system of the savings in Federal expenditures on the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that are associated with the asset verification program requirement added under section 2(a). Beginning with the first year that begins on or after the date of enactment of this Act, each State shall submit to the Secretary, as part of the triennial review required under the Payment Error Rate Measurement program of the Centers for Medicare & Medicaid Services, a report, that the Secretary shall make publicly available, on the activities of the State relating to eligibility determinations and renewals conducted during the year for which the report is submitted, and which includes, with respect to such year, the following information: The number of eligibility renewals initiated, and asset checks conducted, beneficiaries renewed on a total and ex parte basis. The number of asset checks conducted out of the number of new applications initiated and the number of applicants determined eligible after such checks. Such other information related to eligibility determinations and renewals during such month, as identified by the Secretary. For purposes of applying the reporting requirements of paragraph (1) to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa, the Secretary shall promulgate regulations to modify such requirements so that they are similar to the reporting requirements that apply under such paragraph to the 50 States and the District of Columbia but are reasonable given the circumstances of each such territory. The Secretary may assess a State’s compliance with all Federal requirements applicable to eligibility determinations, redeterminations, and Medicaid payment error rate measurement (PERM) reporting requirements, and, if the Secretary determines that a State did not comply with any such requirements during the 180 day period preceding the assessment, the Secretary may require the State to submit and implement a corrective action plan in accordance with paragraph (2). A State that receives a written notice from the Secretary that the Secretary has determined that the State is not in compliance with a requirement described in paragraph (1) shall— not later than 90 days after receiving such notice, submit a corrective action plan to the Secretary; not later than 90 days after the date on which such corrective action plan is submitted to the Secretary, receive approval or disapproval for the plan from the Secretary; and begin implementation of such corrective action plan not later than 90 days after such approval.