MISSISSIPPI LEGISLATURE
2026 Regular Session
To: Public Health and Welfare
By: Senator(s) Hill
AN ACT TO AMEND SECTION 43-12-5, MISSISSIPPI CODE OF 1972, TO REQUIRE THAT ELIGIBILITY VERIFICATIONS FOR CERTAIN ASSISTANCE PROGRAMS BE PERFORMED AT LEAST QUARTERLY BETWEEN ELIGIBILITY REDETERMINATIONS; TO CREATE NEW SECTION 43-12-6, MISSISSIPPI CODE OF 1972, TO REQUIRE THE DIVISION OF MEDICAID (DIVISION) AND THE DEPARTMENT OF HUMAN SERVICES (DEPARTMENT) TO ASSESS CONTINUED ELIGIBILITY BASED ON REVIEW OF DATA FROM CERTAIN FEDERAL SOURCES; TO CREATE NEW SECTION 43-12-10, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT NO INDIVIDUAL WHO IS NOT A UNITED STATES CITIZEN OR A NATIONAL OF THE UNITED STATES SHALL BE ELIGIBLE FOR PARTICIPATION IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR FOR MEDICAID UNLESS THE INDIVIDUAL MEETS THE DEFINITION OF AN ELIGIBLE ALIEN UNDER 7 USC § 2015(F) OR 42 USC § 1396B(V), AS THE CASE MAY BE, AND MEETS THE DEFINITION OF A QUALIFIED ALIEN UNDER 8 USC § 1641(B); TO REQUIRE VERIFICATION OF CITIZENSHIP OR ELIGIBLE ALIEN STATUS DURING ENROLLMENT AND ELIGIBILITY REDETERMINATIONS; TO REQUIRE SUBMISSION TO APPROPRIATE LAW ENFORCEMENT AUTHORITIES INFORMATION CONCERNING ANY HOUSEHOLD MEMBER DETERMINED TO BE AN UNLAWFULLY PRESENT ALIEN; TO REQUIRE THE DEPARTMENT AND THE DIVISION TO SUBMIT INFORMATION CONCERNING ANY HOUSEHOLD MEMBER FOR WHOM THEY ARE UNABLE TO VERIFY ELIGIBLE ALIEN STATUS; TO DIRECT THE DIVISION TO REQUIRE HOSPITALS THAT ACCEPT MEDICAID TO INCLUDE A PROVISION ON ADMISSION OR REGISTRATION FORMS FOR INFORMATION ABOUT A PATIENT'S CITIZENSHIP OR IMMIGRATION STATUS AND TO SUBMIT QUARTERLY REPORTS THAT INCLUDE THE NUMBER OF ADMISSIONS OR EMERGENCY DEPARTMENT VISITS BASED ON CITIZENSHIP AND IMMIGRATION STATUS; TO REQUIRE THE DIVISION TO SUBMIT ANNUAL REPORTS TO THE GOVERNOR, THE PRESIDENT OF THE SENATE, AND THE SPEAKER OF THE HOUSE OF REPRESENTATIVES THAT INCLUDE THE TOTAL NUMBER OF HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT VISITS FROM HOSPITALS THAT ACCEPT MEDICAID FOR THE PRIOR YEAR BASED ON CITIZENSHIP AND IMMIGRATION STATUS; TO CREATE NEW SECTION 43-12-18, MISSISSIPPI CODE OF 1972, TO LIMIT RETROACTIVE ELIGIBILITY FOR MEDICAID; TO CREATE NEW SECTION 43-12-20, MISSISSIPPI CODE OF 1972, TO SET FORTH FREQUENCY REQUIREMENTS FOR MEDICAID ELIGIBILITY REDETERMINATIONS; TO CREATE NEW SECTION 43-12-24, MISSISSIPPI CODE OF 1972, TO SET FORTH FREQUENCY REQUIREMENTS FOR SNAP ELIGIBILITY RECERTIFICATIONS; TO AMEND SECTION 43-12-29, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE DEPARTMENT SHALL VERIFY CERTAIN INFORMATION PRIOR TO CERTIFICATION OR RECERTIFICATION; TO REQUIRE VERIFICATION THROUGH CERTAIN SOURCES; TO PROHIBIT ACCEPTANCE OF ELIGIBILITY DETERMINATIONS FROM AN EXCHANGE ESTABLISHED UNDER 42 U.S.C. § 18041(C); TO AMEND SECTION 43-12-39, MISSISSIPPI CODE OF 1972, TO INCLUDE ADDITIONAL INFORMATION THAT MUST BE ON THE DEPARTMENT'S ANNUAL REPORT OF SNAP AND TANF BENEFIT SPENDING; TO AMEND SECTION 43-12-41, MISSISSIPPI CODE OF 1972, TO DIRECT THE DIVISION AND THE DEPARTMENT TO REPORT ON EFFORTS TO MINIMIZE ELIGIBILITY ERRORS AND FRAUD AND TO ADD ADDITIONAL INFORMATION REQUIREMENTS FOR SUCH REPORTS; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 43-12-5, Mississippi Code of 1972, is amended as follows:
43-12-5. (1) Definitions. For purposes of Sections 43-12-5 through 43-12-17, except for Section 43-12-10, the following definitions apply:
(a) "Department" means the Division of Medicaid or the Department of Human Services, as the case may be.
(b) "Identity information" means an applicant or recipient's full name, aliases, date of birth, address, social security number and other related information, including, but not limited to, the information in subsection (2)(a) of this section.
(2) Establishment of enhanced eligibility verification service.
(a) The department shall establish and use a computerized income, asset, residence and identity eligibility verification service in order to verify eligibility, eliminate the duplication of assistance, and deter waste, fraud, and abuse within each respective assistance program administered by the department. The information verified shall include, but not be limited to:
(i) Earned and unearned income;
(ii) Employment status and changes in employment;
(iii) Immigration status;
(iv) Residency status, including a nationwide best-address source to verify individuals are residents of the state;
(v) Enrollment status in other state-administered public assistance programs, as available in a cost-efficient manner;
(vi) Financial resources;
(vii) Incarceration status;
(viii) Death records;
(ix) Enrollment status in public assistance programs outside of this state, as available in a cost-efficient manner; and
(x) Potential identity fraud or identity theft.
(b) The department may
issue a Request for Proposals (RFP) from multiple third-party vendors,
regardless of the amount of funds to be expended under the contract, for the
purposes of identifying fraud in the programs described in this chapter and
pursuant to the specifications prescribed in this subsection (2). After
evaluating the proposals submitted, the department shall enter into a
competitively bid contract with a third-party vendor for the purposes of using
and accessing an eligibility verification service by which to verify the
income, assets, residence, identity, and other information in paragraph (a) of
this subsection (2) to prevent fraud, misrepresentation, and inadequate
documentation when determining an applicant's eligibility for assistance before
the distribution of benefits, * * * at least quarterly between
eligibility redeterminations, and during eligibility redeterminations and
reviews, as prescribed in this section. The department may use more than one
(1) eligibility verification service and/or third-party vendor, if doing so is
more cost-efficient. The department may renegotiate an existing contract with
a current vendor for the purposes stated in this paragraph (b) if doing so is
more cost-efficient than issuing a Request for Proposals (RFP) from multiple
third-party vendors. If the department determines that it is not more cost-efficient
to renegotiate an existing contract with a current vendor, the department shall
issue a Request for Proposals (RFP) from multiple third-party vendors as
provided in this paragraph (b), regardless of the amount of funds to be
expended under the contract. The department may also enter into a
competitively bid contract with a third-party vendor to provide information to
facilitate reviews of recipient eligibility conducted by the department.
(c) When the department enters into a competitively bid contract with a third-party vendor or renegotiates an existing contract with a current vendor for the purposes of carrying out this eligibility verification service, the vendor, in partnership with the department, shall be required by contract to establish annualized savings realized from implementation of the eligibility verification service. It is the intent of the Legislature that savings exceed the total yearly cost for implementing the eligibility verification service.
(d) To avoid any conflict of interest, when the department enters into a competitively bid contract with a third-party vendor or renegotiates an existing contract with a current vendor, that primary vendor may not currently or will not be allowed to bid on or be awarded a state contract to run enrollment services.
(e) It shall be the responsibility of the contracted third-party vendor to obtain access to any data, data sources and databases, not already being used by the department, for the purposes of implementing the eligibility verification service. The payment structure for the contracted third-party vendor shall be based on a per-applicant rate.
(f) Nothing in this section shall preclude the department from continuing to conduct additional eligibility verification processes, not detailed in this section, that are currently in practice; and nothing in this section shall require the department or third-party vendor to violate the Fair Credit Reporting Act.
(3) The department shall have the eligibility verification service required by this section implemented and operational not later than July 1, 2019. The department shall submit a report every six (6) months on its progress on implementing the eligibility verification service to the Chairmen of the House and Senate Appropriations Committees, the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee, and the House and Senate Medicaid Committees. The report also shall be provided to the other members of the Legislature upon request.
(4) (a) As used in this subsection, the following terms shall be defined as provided in this paragraph:
(i) "Abuse" includes any practice that is inconsistent with acceptable fiscal, business or medical practices that unnecessarily increase cost.
(ii) "Fraud" means misrepresenting the truth to obtain an unauthorized benefit.
(b) The department shall enter or have entered into a competitively bid contract with a third-party vendor for the purposes of identifying waste, abuse and fraud in the programs administered by the department, focusing on detecting and preventing abuse and fraud by providers of services in those programs, and recovering improper payments made to providers of services in those programs.
SECTION 2. The following shall be codified as Section 43-12-6, Mississippi Code of 1972:
43-12-6. Required eligibility verification procedures using federal data sources. (1) At least once a month, the department shall assess continued eligibility and act on any changes that may affect eligibility based on a review of data from the following federal sources:
(a) From the United States Social Security Administration, earned income information, death register information, incarceration records, supplemental security income information, beneficiary records, earnings information and pension information;
(b) From the United States Department of Health and Human Services, income and employment information maintained in the National Directory of New Hires database and child support enforcement data;
(c) From the United States Department of Housing and Urban Development, payment and earnings information;
(d) From the United States Federal Bureau of Investigation, national fleeing felon information; and
(e) From the United States Postal Service, change of address information.
(2) Nothing in this section shall be construed to prohibit the department from verifying eligibility or changes in circumstances using additional data sources, including, but not limited to, other federal, state and commercial data sources.
SECTION 3. The following shall be codified as Section 43-12-10, Mississippi Code of 1972:
43-12-10. Eligible aliens for welfare and enhanced verification of citizenship or immigration status. (1) As used in this section, "department" means the Department of Human Services, and "division" means the Division of Medicaid.
(2) No individual who is not a United States citizen or a national of the United States shall be eligible for participation in the Supplemental Nutrition Assistance Program (SNAP), unless that individual meets the definition of an eligible alien under 7 USC § 2015(f) and meets the definition of a qualified alien under 8 USC § 1641(b).
(3) No individual who is not a United States citizen or a national of the United States shall be eligible for Medicaid, unless that individual meets the definition of an eligible alien under 42 USC § 1396b(v) and meets the definition of a qualified alien under 8 USC § 1641(b).
(4) The department shall be required to verify that an individual is eligible under subsection (1) of this section and the division shall be required to verify that an individual is eligible under subsection (2) of this section during enrollment and eligibility redeterminations by verifying citizenship or eligible alien status using the Systematic Alien Verification for Entitlements (SAVE) service or by requiring the individual to provide an acceptable form of proof of citizenship or eligible alien status, including, but not limited to, certified birth certificates, United States passports and United States Citizenship and Immigration Services documentation.
(5) The department and the division shall submit to the appropriate law enforcement authorities, including, but not limited to, the United States Department of Homeland Security, information concerning any household member that the department or the division, as the case may be, has determined to be an unlawfully present alien, regardless of whether such household member is applying to participate in the program as a member of such household.
(6) The department shall submit to the United States Department of Agriculture information concerning any household member for whom it is unable to verify eligible alien status, regardless of whether such household member is applying to participate in SNAP as a member of such household.
(7) The division shall submit to the United States Department of Health and Human Services information concerning any household member for whom it is unable to verify eligible alien status, regardless of whether such household member is applying for Medicaid as a member of such household.
(8) The entire income and financial resources of any individual rendered ineligible for participation in SNAP under 7 USC § 2015(f) shall be considered in determining the eligibility and benefit allotment of the household of which such individual is a member.
(9) The division shall adhere to the following requirements regarding the reasonable opportunity period for verification of United States citizenship or eligible alien status for Medicaid:
(a) When an applicant's status cannot be verified through available data sources, the division shall provide only a single reasonable opportunity period, consistent with the minimum period required under federal law, for the applicant to provide verification.
(b) Medicaid coverage may only be provided on a provisional basis during the reasonable opportunity period.
(c) Failure to submit acceptable documentation within the reasonable opportunity period required under federal law shall result in denial or termination of Medicaid eligibility, subject to required notice.
(d) No additional reasonable opportunity period shall be granted to any applicant who has previously been denied eligibility at any time due to a failure to verify citizenship or eligible alien status.
(10) The division shall require a field for citizenship or eligible alien status on all presumptive eligibility applications. The division shall require hospitals, clinics, and other qualified entities authorized to conduct presumptive eligibility determinations to collect and transmit attestations of citizenship or eligible alien status to the division. No presumptive eligibility application shall be approved unless the applicant certifies that they are a United States citizen, United States national, or alien eligible for Medicaid under 42 USC § 1396b(v) and subsection (3) of this section.
(11) The division shall:
(a) Require each hospital that accepts Medicaid to do all of the following:
(i) Include a provision on its patient admission or registration forms for the patient or the patient's representative to state or indicate whether the patient is a United States citizen or lawfully present in the United States or is not lawfully present in the United States.
(ii) Notify a patient, at the time the information under subparagraph (i) of this paragraph (a) is collected, that any submission made on an admission or registration form will not affect patient care, as required by federal law.
(iii) Submit a quarterly report to the division within thirty (30) days after the end of each calendar quarter that includes the number of hospital admissions or emergency department visits within the previous quarter that were made by a patient or a patient's representative who indicated that the patient was a United States citizen or lawfully present in the United States, that the patient was not lawfully present in the United States, or that the patient or patient's representative declined to answer.
(b) By April 1 of each year, submit a report to the Governor, the President of the Senate, and the Speaker of the House of Representatives that includes the total number of hospital admissions and emergency department visits from hospitals that accept Medicaid for the previous calendar year for which the patient or patient's representative reported that the patient was a United States citizen or lawfully present in the United States, that the patient was not lawfully present in the United States, or that the patient or patient's representative declined to answer. The report must also describe information relating to the costs of uncompensated care for aliens who are not lawfully present in the United States, the impact of uncompensated care on the cost or ability of hospitals to provide services to the public, hospital funding needs and other related information.
(c) Adopt rules relating to the format and information to be contained in quarterly reports under paragraph (a)(iii) of this subsection (11) and the acceptable formats for hospitals to use in requesting information regarding a patient's immigration status on hospital admission or registration forms.
SECTION 4. The following shall be codified as Section 43-12-18, Mississippi Code of 1972:
43-12-18. Retroactive eligibility for Medicaid. The Division of Medicaid shall limit retroactive eligibility for Medicaid for an individual to no more than two (2) months prior to the month in which the individual submits a completed Medicaid application.
SECTION 5. The following shall be codified as Section 43-12-20, Mississippi Code of 1972:
43-12-20. Medicaid eligibility redeterminations. (1) Unless prohibited by federal law, the Division of Medicaid shall conduct eligibility redeterminations for all nonelderly adult Medicaid recipients based upon the application of Modified Adjusted Gross Income standards under 42 CFR § 435.603 at least once every six (6) months.
(2) The Division of Medicaid shall conduct eligibility redeterminations for all Medicaid recipients not described in subsection (1) of this section at least once every twelve (12) months.
SECTION 6. The following shall be codified as Section 43-12-24, Mississippi Code of 1972:
43-12-24. Supplemental Nutrition Assistance Program (SNAP) eligibility recertification frequency. (1) The Department of Human Services shall assign certification periods of no more than four (4) months' duration to households with zero (0) net income, households that include an able-bodied adult without dependents, or other households whose circumstances are determined by the Department of Human Services to be unstable, unless otherwise prohibited under federal law for SNAP.
(2) The Department of Human Services shall assign certification periods for a duration of one (1) or two (2) months to households that the Department of Human Services determines will become ineligible for SNAP in the near future, unless otherwise prohibited under federal law.
SECTION 7. Section 43-12-29, Mississippi Code of 1972, is amended as follows:
43-12-29. (1) The Department of Human Services shall verify identity, household composition, expenses, and any other factor affecting eligibility allowed under 7 CFR Section 273.2(f)(3) prior to certification or recertification.
(2) The Department of Human Services shall not accept the self-attestation or self-declaration of an applicant or enrollee as verification of income, assets or expenses unless such verification is strictly unavailable due to circumstances beyond an applicant or enrollee's control and federal regulations explicitly require the acceptance of such statement to preserve the applicant or enrollee's due process rights.
(3) For the purposes of this section, "verification" means independent confirmation of the information provided by an applicant or enrollee through:
(a) Third-party data matching sources;
(b) Documentary evidence provided by the source of the income; or
(c) Direct contact with the income source.
(4) If any discrepancy exists between an applicant's or enrollee's statement and third-party data matching sources, the Department of Human Services shall investigate the discrepancy and shall not certify the applicant or recertify the enrollee until the discrepancy is resolved by independent documentary evidence.
(5) The Division of Medicaid shall not accept an eligibility determination from an Exchange established under 42 USC § 18041(c).
(6) The Division of Medicaid may accept an assessment from an Exchange established under 42 USC § 18041(c), provided that the Division of Medicaid makes the eligibility determination.
(7) Except where required by federal law, the Division of Medicaid shall not accept self-attestation of income, residency, age, household composition, caretaker or relative status, or receipt of other coverage without verification of such information prior to enrollment.
SECTION 8. Section 43-12-39, Mississippi Code of 1972, is amended as follows:
43-12-39. (1) The Department of Human Services shall post on its website and make available on an annual basis to the chairmen of the House and Senate Appropriations Committees, the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee a report of SNAP and TANF benefit spending. The report also shall be provided to the other members of the Legislature upon request.
(2) The report required under subsection (1) of this section shall include:
(a) The dollar amount and number of transactions of SNAP benefits that are accessed or spent out-of-state, disaggregated by state;
(b) The dollar amount and number of transactions of TANF benefits that are accessed or spent out-of-state, disaggregated by state;
(c) The dollar amount,
number of transactions, and times of transactions of SNAP benefits that are
accessed or spent in-state, disaggregated by retailer, institution, or
location, unless expressly prohibited by federal law; * * *
(d) The dollar amount,
number of transactions, and time of transactions of TANF benefits that are
accessed or spent in-state, disaggregated by retailer, institution, or location * * *; and
(e) The number of households in which transactions occurred exclusively outside this state for a continuous period of sixty (60) days or more during the reporting period.
(3) The report required under subsection (1) of this section shall be de-identified to prevent identification of individual recipients.
SECTION 9. Section 43-12-41, Mississippi Code of 1972, is amended as follows:
43-12-41. (1) The Division of Medicaid and the Department of Human Services shall provide on an annual basis to the Chairmen of the House and Senate Appropriations Committees, the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee, and the House and Senate Medicaid Committees, a report of characteristics of recipients of Medicaid, SNAP and TANF benefits and efforts by the Division of Medicaid and the Department of Human Services to minimize eligibility errors and fraud. The report also shall be provided to the other members of the Legislature upon request.
(2) The report required under subsection (1) of this section shall include:
(a) The length of enrollment, disaggregated by program and eligibility group;
(b) The share of recipients concurrently enrolled in one or more additional means-tested programs, disaggregated by program and eligibility group;
(c) The number of means-tested programs recipients are concurrently enrolled in, disaggregated by program and eligibility group;
(d) The demographics
and characteristics of recipients, disaggregated by program and eligibility
group; * * *
(e) The dollar amount
spent on advertising and marketing for TANF, SNAP, Medicaid, and other means-tested
programs, including both state and federal funds, disaggregated by program * * *;
(f) The number of households investigated for intentional program violations or fraud;
(g) The total number of households referred to the Attorney General's Office for prosecution;
(h) The total dollar amount of improper payments and expenditures;
(i) The total dollar amount of monies recovered;
(j) The aggregate data concerning improper payments and ineligible recipients as a percentage of those investigated and reviewed;
(k) The list of the databases and sources used to detect eligibility errors and fraud;
(l) The number of households flagged by each database as ineligible for the program;
(m) The number of cases in which benefits were adjusted or terminated due to overpayments being made;
(n) The metrics regarding timeliness, including, but not limited to:
(i) The median number of days from the date a database or source flags an eligibility error until the date the Division of Medicaid or the Department of Human Services initiates verification of the flagged eligibility error;
(ii) The median number of days from the date the Division of Medicaid or the Department of Human Services initiates verification of an eligibility error flagged by a database or source until the date that verification is completed;
(iii) The percentage of verifications of eligibility errors flagged by a database or source that were completed within thirty (30) days, within sixty (60) days and within ninety (90) days; and
(iv) The number of verifications of eligibility errors flagged by a database or source that remain pending for longer than ninety (90) days as of the first day of February in the year the report is due;
(o) A comparison of the data reported under this subsection with the preceding year's report, highlighting trends in match volumes, error rates and recovery outcomes;
(p) A summary of corrective actions identified in the prior annual report and the status of their implementation; and
(q) A brief narrative describing material delays, impediments or systemic data quality issues encountered during the past twelve (12) months, corrective actions taken to address such issues, interagency or multistate cooperative activities undertaken and recommendations for statutory, regulatory or operational changes to improve program integrity and timeliness.
(3) The report required under subsection (1) of this section shall be de-identified to prevent identification of individual recipients.
SECTION 10. This act shall take effect and be in force from and after its passage.