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Pennsylvania House of Representatives
06/01/2024 03:22 AM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?SPick=20230&chamber=H&cosponId=38765
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House of Representatives
Session of 2023 - 2024 Regular Session

MEMORANDUM

Posted: December 16, 2022 09:07 AM
From: Representative Seth M. Grove
To: All House members
Subject: Medical Assistance Eligibility Redeterminations and Maintenance of Effort
 
Soon I will be introducing legislation to require the Dept. of Human Services to initiate a redetermination of eligibility for recipients of Medical Assistance (Medicaid).

By way of background, the enhanced FMAP dollars received by the Commonwealth under the federal CARES Act had strings attached. This legislation addresses two of these strings: ineligible recipients and maintenance of effort. Any state accepting enhanced FMAP dollars could not remove ineligible individuals from their Medicaid program and must maintain the same level of funding for all programs. The ban on removing ineligible individuals will shortly expire.

Specifically, this legislation will mandate the Department to:
  • Regardless of federal law, the Department shall continue its redetermination processes.
  • Request approval from US Dept. of HHS to continue eligibility redeterminations during periods of restrictions.
  • Carry out an additional check on eligibility under section 441.9 of the Human Services Code.
  • Complete and submit an internal audit.
  • Require redeterminations and removal of ineligible individuals beginning on the first day of the first full quarter after this legislation becomes law.
This legislation is an important step in providing the common sense financial and integrity provisions into our safety net programs to ensure finite tax dollars are available for our most vulnerable citizens.
I hope you will join me in cosponsoring this legislation.


Introduced as HB1288