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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5547 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  2d Session
                                S. 5547

  To amend title XIX of the Social Security Act to require States to 
   verify certain eligibility criteria for individuals enrolled for 
         medical assistance quarterly, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

            December 17 (legislative day, December 16), 2024

  Mr. Scott of Florida introduced the following bill; which was read 
             twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
  To amend title XIX of the Social Security Act to require States to 
   verify certain eligibility criteria for individuals enrolled for 
         medical assistance quarterly, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Leveraging Integrity and 
Verification of Eligibility for Beneficiaries Act'' or the ``LIVE 
Beneficiaries Act''.

SEC. 2. VERIFICATION OF CERTAIN ELIGIBILITY CRITERIA FOR INDIVIDUALS 
              ENROLLED FOR MEDICAL ASSISTANCE.

    Section 1902 of the Social Security Act (42 U.S.C. 1396a) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (86), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in paragraph (87)(D), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (87)(D) the 
                following new paragraph:
            ``(88) provide that the State shall comply with the 
        eligibility verification requirements under subsection (uu), 
        except that this paragraph shall apply only in the case of the 
        50 States and the District of Columbia.''; and
            (2) by adding at the end the following new subsection:
    ``(uu) Verification of Certain Eligibility Criteria.--
            ``(1) In general.--For purposes of subsection (a)(88), the 
        eligibility verification requirements, beginning January 1, 
        2026, are as follows:
                    ``(A) Quarterly screening to verify enrollee 
                status.--The State shall, not less frequently than 
                quarterly, review the Death Master File (as such term 
                is defined in section 203(d) of the Bipartisan Budget 
                Act of 2013) to determine whether any individuals 
                enrolled for medical assistance under the State plan 
                (or waiver of such plan) are deceased.
                    ``(B) Disenrollment under state plan.--If the State 
                determines, based on information obtained from the 
                Death Master File, that an individual enrolled for 
                medical assistance under the State plan (or waiver of 
                such plan) is deceased, the State shall--
                            ``(i) treat such information as factual 
                        information confirming the death of a 
                        beneficiary for purposes of section 431.213(a) 
                        of title 42, Code of Federal Regulations (or 
                        any successor regulation);
                            ``(ii) disenroll such individual from the 
                        State plan (or waiver of such plan); and
                            ``(iii) discontinue any payments for 
                        medical assistance under this title made on 
                        behalf of such individual (other than payments 
                        for any items or services furnished to such 
                        individual prior to the death of such 
                        individual).
                    ``(C) Reinstatement of coverage in the event of 
                error.--If a State determines that an individual was 
                misidentified as deceased based on information obtained 
                from the Death Master File, and was erroneously 
                disenrolled from medical assistance under the State 
                plan (or waiver of such plan) based on such 
                misidentification, the State shall immediately reenroll 
                such individual under the State plan (or waiver of such 
                plan), retroactive to the date of such disenrollment.
            ``(2) Rule of construction.--Nothing under this subsection 
        shall be construed to preclude the ability of a State to use 
        other electronic data sources to timely identify potentially 
        deceased beneficiaries, so long as the State is also in 
        compliance with the requirements of this subsection (and all 
        other requirements under this title relating to Medicaid 
        eligibility determination and redetermination).''.
                                 <all>
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