Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 21 - MEDICAID ELIGIBILITY VERIFICATION SYSTEM (§§ 20-77-2101 — 20-77-2105) › Section 20-77-2104 - Medicaid eligibility verification

(a)
Except when prohibited by federal law, the Department of Human Services shall adopt the following procedures to verify Medicaid eligibility for participation in the Arkansas Medicaid Program or receipt of benefits in the Arkansas Medicaid Program:
(1)
All conditions of eligibility for Medicaid assistance shall be verified before authorization of Medicaid assistance and during a reevaluation of a recipient's eligibility; and
(2)
(A)
Except when prohibited by federal law, a condition of eligibility for assistance is that an applicant or recipient consents to the disclosure of information about the age, residence, citizenship, employment, applications for employment, income, and resources of the applicant or recipient that are in the possession of third parties.
(B)
The consent described in subdivision (a)(2)(A) of this section shall be effective to empower any third party to release information requested by the Department of Human Services.
(b)
(1)
The Department of Human Services shall enter into a data matching agreement with the Office of the Arkansas Lottery and the Arkansas Racing Commission to identify individuals with substantial winnings.
(2)
On at least a quarterly basis, the Department of Human Services shall review this information and act on any changes that may affect eligibility consistent with
42 U.S.C. § 1396
, as existing on January 1, 2021.
(c)
The Department of Human Services shall review information:
(1)
From the Department of Health concerning individuals enrolled in Medicaid assistance that indicates a change in circumstances, including without limitation death certificates, that may affect eligibility, on at least a monthly basis;
(2)
From the Division of Workforce Services and the Department of Finance and Administration concerning individuals enrolled in assistance that indicates a change in circumstances that may affect eligibility, including without limitation a change in employment or wages, on at least a quarterly basis;
(3)
Concerning individuals enrolled in assistance that indicates a change in circumstances that may affect eligibility, including without limitation potential changes in residency as identified by out-of-state electronic benefit transfer transactions, on at least a monthly basis; and
(4)
From the Department of Corrections and the Division of Correction concerning individuals enrolled in Medicaid assistance that indicates a change in circumstances that may affect eligibility.
(d)
Annually, the Department of Human Services shall make available to the public on its website data, including without limitation information regarding noncompliance and fraud investigations in assistance for the following aggregate and nonconfidential and nonpersonally identifying information:
(1)
The number of assistance cases investigated for intentional Arkansas Medicaid Program violations or fraud;
(2)
The total number of assistance cases referred for prosecution;
(3)
Improper payments and expenditures;
(4)
Monies recovered; and
(5)
Aggregate data concerning improper payments and ineligible recipients as a percentage of those investigated and reviewed.
(e)
If the Department of Human Services receives information concerning an individual enrolled in Medicaid assistance that indicates a change in circumstances that may affect eligibility, the Department of Human Services shall review the individual's or household's case.
(f)
The Department of Human Services may execute a memorandum of understanding with any other state department, agency, or division for information required to be shared between agencies under this section.
Added by Act 2021, No. 780,§ 4, eff. 7/28/2021.