SB140 Alabama 2018 Session

Summary

Primary Sponsor

Arthur OrrSenator

Republican

Session

Regular Session 2018

Title

Medicaid, eligibility verification requirements required, referral of fraud for prosecution, agency required to implement work requirements, exceptions

Summary

SB 140 would require Alabama Medicaid to tighten eligibility verification, possibly use third-party vendors, implement semi-annual checks, pursue fraud prosecutions, report findings, and impose work requirements with exemptions.

What This Bill Does

The bill would require the Medicaid Agency to verify applicant eligibility before enrollment using data such as income, employment, immigration, residency, resources, and more. It allows contracting with independent vendors to perform verifications and to achieve verified savings. It mandates semi-annual eligibility reviews after initial enrollment and establishes a formal process for disputes and fraud referrals to district attorneys, plus annual reporting on effectiveness. It also creates work requirements for Medicaid eligibility, with several exemptions, and authorizes state plan amendments or waivers to implement those requirements.

Who It Affects

• Medicaid applicants and current enrollees would face more thorough eligibility checks and potential changes to their benefits if discrepancies are found, and would need to meet work or work-related activity requirements or qualify for exemptions.
• The Alabama Medicaid Agency, third-party verification vendors, district attorneys, and state policymakers would coordinate data sharing, implement verification and dispute procedures, pursue fraud referrals, and receive annual effectiveness reports and waivers if needed.

Key Provisions

• Before awarding assistance, verify eligibility information for applicants, including income, employment, immigration status, residency, enrollment in other programs, resources, incarceration, death records, and identity-related data; may share information via memoranda of understanding with other state agencies.
• Agency may contract with independent vendors to provide verification data; such contracts (except for certain federal-mandated contracts) must show annual savings exceeding the contract's cost; agency may pursue multi-state cooperation and the National Accuracy Clearinghouse.
• Semi-annual eligibility verification after initial enrollment; review the same types of information; establish procedures for disputes, including notices, responses, documentation, and opportunities to explain discrepancies; discontinue benefits only after due process is completed.
• Refer suspected fraud to the appropriate district attorney; provide annual written reports to the Governor, Legislature leadership, and the Department of Finance detailing effectiveness, cases reviewed, closures, referrals, recoveries, dispositions, and savings.
• Impose work requirements for Medicaid eligibility (20 hours per week, or combination of work, work programs, volunteering, or workfare) with several exemptions (age under 19, over 65, medical unfitness, pregnancy, caregiver of young child or dependent with serious disability/medical conditions, unemployment benefits, and treatment programs), and require state plan amendments or waivers to implement.
• Agency may adopt rules to administer the act, and the non-exemption portions of the act become effective three months after passage and governor approval (with Section 6's rulemaking effective upon approval and waiver).

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Medicaid