Verify Eligibility Coverage Act

To amend titles XI and XIX of the Social Security Act to promote program integrity with respect to the enrollment of certain immigrants in State plans under Medicaid, and for other purposes. 1. Short title This Act may be cited as the Verify Eligibility Coverage Act 2. Promoting program integrity in enrolling certain immigrants under Medicaid (a) In general Section 1137(f) of the Social Security Act ( 42 U.S.C. 1320b–7(f) (1) by striking Subsections (a)(1) and (d) (1) Subsections (a)(1) and (d) (2) by adding at the end the following new paragraph: (2) (A) Subparagraphs (A) and (B)(ii) of subsection (d)(4) shall not apply in the case of an initial determination made on or after the date that is 6 months after the date of the enactment of this paragraph with respect to the eligibility of an alien described in subparagraph (B) for benefits under the program listed in subsection (b)(2). (B) An alien described in this subparagraph is an individual declaring to be a citizen or national of the United States with respect to whom a State, in accordance with section 1902(a)(46)(B), requires— (i) pursuant to section 1902(ee), the submission of a social security number; or (ii) pursuant to section 1903(x), the presentation of satisfactory documentary evidence of citizenship or nationality. . (b) No payments for medical assistance provided before presentation of evidence Section 1903(i)(22) of the Social Security Act ( 42 U.S.C. 1396b(i)(22) (1) by striking with respect to amounts expended (A) with respect to amounts expended (2) by inserting and (3) by adding at the end the following new subparagraph: (B) in the case of a State that elects to provide a reasonable period to present satisfactory documentary evidence of such citizenship or nationality pursuant to paragraph (2)(C) of section 1902(ee) or paragraph (4) of subsection (x) of this section, for amounts expended for medical assistance for such an individual (other than an individual described in paragraph (2) of such subsection (x)) during such period; . (c) Conforming amendments Section 1137(d)(4) of the Social Security Act ( 42 U.S.C. 1320b–7(d)(4) (1) in subparagraph (A), in the matter preceding clause (i), by inserting subject to subsection (f)(2), the State (2) in subparagraph (B)(ii), by inserting subject to subsection (f)(2), pending such verification 3. Medicaid Improvement Fund Section 1941 of the Social Security Act ( 42 U.S.C. 1396w–1(b) 1941. Medicaid Improvement Fund (a) In general The Secretary shall establish, and administer, under this title a Medicaid Improvement Fund (in this section referred to as the Fund (1) To improve the management of the Medicaid program by the Centers for Medicare & Medicaid Services, including oversight of contracts and contractors and evaluation of demonstration projects. (2) To improve access to care for the most vulnerable individuals eligible to receive medical assistance under the State plan under this title (or a waiver of such plan), including by carrying out section 4 of the Verify Eligibility Coverage Act (b) Supplement, not supplant Payments made for activities under this section shall be in addition to payments that would otherwise be made for activities described in subsection (a). (c) Funding (1) In general (A) Management improvements There shall be available to the Fund, for the purposes described in subsection (a)(1), for expenditures from the Fund for fiscal year 2021 and thereafter, $5,000,000. (B) Increasing access There shall be available to the Fund, for the purposes described in subsection (a)(2), for expenditures from the Fund for fiscal year 2020 and thereafter, $1,095,000,000. (2) Funding limitation Amounts in the Fund shall be available in advance of appropriations but only if the total amount obligated from the Fund does not exceed the amount available to the Fund under subparagraphs (A) and (B) of paragraph (1). The Secretary may obligate funds from the Fund only if the Secretary determines (and the Chief Actuary of the Centers for Medicare & Medicaid Services and the appropriate budget officer certify) that there are available in the Fund sufficient amounts to cover all such obligations incurred consistent with the previous sentence. . 4. Providing care for the most vulnerable patients on waiting lists (a) In general Subject to subsection (d), the Secretary of Health and Human Services shall provide, for each of fiscal years 2020 through 2028, payment to eligible States selected under subsection (c) to provide for medical assistance for home and community-based services under a State plan waiver under subsection (c), (d), or (i) of section 1915 of the Social Security Act ( 42 U.S.C. 1396n 42 U.S.C. 1315 (b) State eligibility A State is eligible for a payment under this section if the State submits an application to the Secretary at such time, in such form and manner, and containing such information, provisions, and assurances, as specified by the Secretary. (c) Selection Subject to subsection (d), the Secretary shall, for each of fiscal years 2020 through 2028, select, on a competitive basis, from among eligible States, the States that will receive payment under this section. In making such selections, the Secretary shall give priority to— (1) States with the highest number of individuals on a waiting list described in subsection (a); (2) States with the highest average or highest median periods individuals have been on such a list; and (3) States with individuals on such a list who have the lowest income levels, as compared to the income of individuals on such a list of other eligible States. (d) Funding (1) Funds allocated to States Of the funds available for purposes of carrying out this section under section 1941(c) of the Social Security Act ( 42 U.S.C. 1396w–1(c) (2) Payments to States For each calendar quarter beginning on or after October 1, 2019, the Secretary shall pay to each State selected under subsection (c), from the allocation made to the State under paragraph (1), an amount equal to 90 percent of the Federal medical assistance percentage of the amount expended during such quarter for the medical assistance described in subsection (a). (e) Definitions In this section: (1) Federal medical assistance percentage The term Federal medical assistance percentage 42 U.S.C. 1396d(b) (2) Medical assistance The term medical assistance 42 U.S.C. 1396d(a) (3) State The term State 42 U.S.C. 1396

Summary: Verify Eligibility Coverage Act This bill allows a state to delay or deny an individual's initial eligibility for Medicaid benefits without providing a reasonable opportunity to submit evidence of a satisfactory immigration status or pending official verification of such status. A state that elects to provide a reasonable period for an individual to provide such evidence may not receive payment for amounts expended on the individual's medical assistance during that period. In FY2020-FY2028, the Centers for Medicare & Medicaid Services, using the Medicaid Improvement Fund, shall pay a 90% Federal Medical Assistance Percentage (i.e., federal matching rate) to eligible states for home- and community-based services furnished under a state Medicaid waiver to patients who had been on a waiting list for such services.