SB195 Summary

• Alabama Medicaid Agency must verify applicant eligibility prior to enrollment, including earned/unearned income, employment status, immigration status, residency, incarceration status, death records, and potential identity fraud.

• Agency may contract with third-party vendors to obtain verification information if annualized savings exceed the contract's total annual cost to the state.

• Agency must conduct quarterly eligibility reviews of enrolled individuals and implement knowledge-based identity authentication examinations before awarding assistance, with multiple submission channels (online, in-person, phone).

• Individuals must be given written notice describing discrepancies, 10 business days to respond in writing, and opportunity to dispute findings; assistance cannot be discontinued until notice and opportunity to respond are provided.

• Agency must refer suspected fraud cases to the Attorney General or district attorney and provide quarterly reports to the Governor, Legislature, and Department of Finance detailing case reviews, closures, prosecutions, and cost savings.