Protecting Medicaid Beneficiaries Act of 2022
Bill: S.3917 | Sponsor: Sen. Inhofe, James M. (R-OK)
Policy area: Health

Summary:
Protecting Medicaid Beneficiaries Act of 2022
This bill requires states and U.S. territories to implement asset verification programs and resources tests for all enrollees as a condition of Medicaid eligibility (such requirements are currently generally limited to individuals who are eligible for Medicaid on the basis of being aged, blind, or disabled, and do not apply in all U.S. territories).
The Centers for Medicare & Medicaid Services (CMS) must distribute any resulting federal savings to states for two years; states may use the funds to support maternal and child health under Medicaid or for other purposes that are approved by the CMS. The CMS must also track and report on any savings. The Government Accountability Office must report on the efficacy of the asset verification programs.

To apply the Medicaid asset verification program to all applicants for, 
 and recipients of, medical assistance in all States and territories, 
                        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 ``Protecting Medicaid Beneficiaries 
Act of 2022''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Recent estimates show that the Social Security program 
        loses over $4,000,000,000 per year to fraud.
            (2) In fiscal year 2020, the Medicaid program lost 
        $86,490,000,000 in improper payments and the Medicare program 
        lost another almost $43,000,000,000.
            (3) The fiscal year 2020 national Children's Health 
        Insurance Program (CHIP) improper payment rate estimate is 27 
        percent, representing $4,780,000,000 in improper payments.
            (4) Millions of Americans experience homelessness, hunger, 
        or lack of healthcare coverage. Yet, our country annually 
        wastes more than $130,000,000,000 in the very programs that 
        were designed to correct these serious problems, demonstrating 
        that our system is failing those who need it the most.

SEC. 3. APPLICATION OF MEDICAID ASSET TEST TO ALL APPLICANTS FOR, AND 
              RECIPIENTS OF, MEDICAL ASSISTANCE IN ALL STATES AND 
              TERRITORIES.

    (a) In General.--Section 1940 of the Social Security Act (42 U.S.C. 
1396w) is amended--
            (1) in subsection (a), by striking paragraph (4); and
            (2) in subsection (b)(1)(A), by striking ``on the basis of 
        being aged, blind, or disabled''.
    (b) Rules.--The Secretary of Health and Human Services shall 
promulgate such rules as are necessary to implement the amendments made 
by subsection (a).
    (c) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by subsection (a) shall take effect on the date that is 2 
        years after the date of enactment of this Act.
            (2) Phase-in of implementation.--
                    (A) In general.--During the 2-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 
                asset verification program that meets the requirements 
                under section 1940 of the Social Security Act (as 
                amended by subsection (a)).
                    (B) Implementation before effective date.--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).
                    (C) Delay of effective date.--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.

SEC. 4. MEDICAID RESOURCES ELIGIBILITY REQUIREMENT.

    (a) In General.--Section 1902(e)(14)(C) of the Social Security Act 
(42 U.S.C. 1396a(e)(14)(C)) is amended to read as follows--
                    ``(C) Resources test requirement.--
                            ``(i) In general.--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) Requirement.--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.''.
    (b) No Effect on Continuous Eligibility for Pregnant Women.--
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.
    (c) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendment 
        made by subsection (a) shall take effect on the date that is 2 
        years after the date of enactment of this Act.
            (2) Rule for changes requiring state legislation.--In the 
        case of a State plan under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.) which the Secretary of Health and 
        Human Services determines requires State legislation (other 
        than legislation appropriating funds) in order for the State 
        plan to meet the additional requirement imposed by the 
        amendment made by subsection (a), the State plan shall not be 
        regarded as failing to comply with the requirements of such 
        title solely on the basis of its failure to meet this 
        additional requirement before the first day of the first 
        calendar quarter beginning after the close of the first regular 
        session of the State legislature that begins after the 
        effective date of this Act. For purposes of the previous 
        sentence, in the case of a State that has a 2-year legislative 
        session, each year of such session shall be deemed to be a 
        separate regular session of the State legislature.

SEC. 5. ALLOWING STATES TO RETAIN SAVINGS FROM ASSET VERIFICATION 
              PROGRAM AND RESOURCES ELIGIBILITY REQUIREMENTS.

    (a) In General.--For each of the first 2 years following the date 
that is 2 years after the date of enactment of this Act, the Secretary 
of Health and Human Services shall pay to the State an amount equal to 
the savings (as estimated by the Secretary) in Federal expenditures 
that are attributable to the State meeting the requirements imposed by 
the amendments made by sections 3 and 4.
    (b) Use of Funds.--A State that receives a payment under subsection 
(a) shall use the funds received under such payment to support 
enrollment in, and the conduct of, programs for maternal and child 
health under the State Medicaid program, or for such other purpose in 
support of the State Medicaid program as the Secretary of Health and 
Human Services shall approve.

SEC. 6. REQUIRING CMS TO TRACK STATE ASSET VERIFICATION PROGRAMS.

    (a) Tracking Asset Verification Program Savings.--No later than 3 
years after the date of 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 3(a).
    (b) Reports to Congress.--Beginning in the fifth year after the 
date of enactment of this Act, the Administrator of the Centers for 
Medicare & Medicaid Services shall issue biannual reports to Congress 
detailing the performance of State Medicaid asset verification programs 
during the applicable reporting period. Each such report shall 
include--
            (1) an overview of the savings, both pre- and post-
        reporting period, attributed to such programs; and
            (2) any material changes to the composition of the State 
        Medicaid populations as a result of such programs.

SEC. 7. GAO REPORT TO CONGRESS ON THE EFFICACY OF STRENGTHENING THE 
              FISCAL INTEGRITY OF THE MEDICAID PROGRAM.

    No sooner than 5 years after the date of enactment of this Act, the 
Comptroller General of the United States shall submit to the Committee 
on Finance of the Senate and the Committee on Energy and Commerce of 
the House of Representatives a report that assesses the efficacy of 
State asset verification programs that meet the requirements of section 
1940 of the Social Security Act (42 U.S.C. 1396w) (as amended by 
section 3(a)). Such report shall include--
            (1) an overview of Medicaid enrollment before and after the 
        implementation of the changes to the asset verification system 
        requirements under such section 1940;
            (2) an overview of Medicaid spending before and after the 
        implementation of such changes;
            (3) information on what is known about the number of 
        individuals who applied for Medicaid or who applied for 
        redetermination of Medicaid and were deemed ineligible due to 
        their financial circumstances (income and resources) after the 
        implementation of such changes; and
            (4) any additional recommendations for further changes to 
        the Medicaid asset verification program requirements under 
        title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
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