Revision: June 7, 2012, midnight
HB 1658-FN – VERSION ADOPTED BY BOTH BODIES
28Mar2012… 1376h
05/16/12 2222s
05/16/12 2333s
6June2012… 2444CofC
2012 SESSION
05/09
HOUSE BILL 1658-FN
AN ACT establishing an income and identity verification system for public assistance recipients; relative to implementation of the Sean William Corey pilot program; extending the moratorium on nursing home beds and rehabilitation beds; and repealing assessments for excess benefits paid by employers in the retirement system.
This bill:
I. Establishes an income and identity verification system for public assistance recipients.
II. Directs the department of health and human services to implement the Sean William Corey pilot program, a previously enacted program to provide home health aide services for medically fragile children.
III. Extends the moratorium on nursing home beds and rehabilitation beds until June 30, 2014.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
28Mar2012… 1376h
05/16/12 2222s
05/16/12 2333s
6June2012… 2444CofC
12-2795
05/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twelve
AN ACT establishing an income and identity verification system for public assistance recipients; relative to implementation of the Sean William Corey pilot program; extending the moratorium on nursing home beds and rehabilitation beds; and repealing assessments for excess benefits paid by employers in the retirement system.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Income and Identity Verification System. Amend RSA 167 by inserting after section 4-b the following new section:
167:4-c Income and Identity Verification System.
I. The department shall enter into a contract with a vendor to identify, investigate, and resolve potential cases of fraud, misrepresentation, or inadequate documentation prior to determining an applicant’s eligibility for assistance under this chapter and RSA 161. The procedures shall ensure that every case is reviewed. Each review shall include utilization of the income and identity verification system established under this section.
II. Payment to the vendor for services provided in this section shall be contingent upon annualized savings realized from implementation of the program, as agreed upon by the commissioner and the vendor.
III. The department shall contract with a vendor to establish a computerized income and identity eligibility verification system in order to verify eligibility, eliminate duplication of assistance, and deter fraud.
IV. Prior to awarding or continuing assistance under this chapter or RSA 161, the department may contract with a vendor, to the extent such data bases are available, match the name, date of birth, and social security number of each applicant and recipient against the following:
(a) Employer quarterly reports of income and unemployment insurance payment information maintained by the department of employment security.
(b) Earned income information maintained by the Social Security Administration.
(c) Immigration status information maintained by the United States Citizenship and Immigration Services.
(d) Death register information maintained by the Social Security Administration.
(e) Prisoner information maintained by the Social Security Administration.
(f) Public housing and Section 8 Housing Assistance payment information maintained by the Department of Housing and Urban Development.
(g) National fleeing felon information maintained by the Federal Bureau of Investigation.
(h) Wage reporting and similar information maintained by states contiguous to this state.
(i) Beneficiary records and earnings information maintained by the Social Security Administration in its Beneficiary and Earnings Data Exchange (BENDEX) database.
(j) Earnings and pension information maintained by the Social Security Administration in its Beneficiary Earnings Exchange Record System (BEERS) database.
(k) Employment information maintained by the department of employment security in its new hire directory database.
(l) Employment information maintained by the United States Department of Health and Human Services in its National Directory of New Hires database.
(m) Supplemental Security Income information maintained by the Social Security Administration in its State Data Exchange (SDX) database.
(n) Veterans’ benefits information maintained by the United States Department of Health and Human Services, in coordination with the Department of Health and Human Services and the Department of Veterans’ Affairs, in the federal Public Assistance Reporting Information System (PARIS) database.
(o) Child care services information maintained by the department of health and human services under its child care assistance program.
(p) Utility payments information maintained by the office of energy and planning under the fuel assistance program.
(q) A database which is substantially similar to or a successor of a database established in this section.
(r) A database of all persons who currently hold a license, permit, or certificate from a state agency.
V. Prior to awarding or continuing assistance under this chapter or RSA 161, the department shall match the name, date of birth, and social security number of each applicant and recipient against the following public records:
(a) A nationwide public records data source of physical asset ownership such as real property, automobiles, watercraft, aircraft and luxury vehicles.
(b) A nationwide public records data source of incarcerated individuals.
(c) A comprehensive public records database that identifies potential identity fraud or identity theft that can closely associate name, social security number, date of birth, phone and address information.
VI. If a discrepancy results between an applicant’s or recipient’s social security number and one or more of the databases or information tools listed under paragraph IV or V, the department shall review the applicant’s or recipient’s case using the following procedures:
(a) If the information discovered under paragraph IV and V does not result in the department finding the applicant or recipient ineligible for assistance under this section, the department shall take no further action.
(b) If the information discovered results in the department finding the applicant or recipient ineligible for assistance, the applicant or recipient shall be given an opportunity to explain the discrepancy. The department shall provide written notice to the applicant or recipient which shall describe in sufficient detail the circumstances of the discrepancy, the manner in which the applicant or recipient may respond, and the consequences of failing to take action. The applicant or recipient shall have 10 business days to respond in an attempt to resolve the discrepancy. The explanation provided by the recipient or applicant shall be given in writing. After receiving the explanation, the department may request additional documentation if it determines that there is a substantial risk of fraud.
(c) If the applicant or recipient does not respond to the notice, the department shall deny assistance for failure to cooperate, in which case the department shall provide notice of intent to discontinue assistance. Eligibility for assistance shall not be reestablished until the discrepancy has been resolved.
(d) If an applicant or recipient responds to the notice and disagrees with the findings of the match between his or her social security number and one or more databases or information tools listed under this section, the department shall reinvestigate the matter. If the department finds that there has been an error, the department shall take immediate action to correct it and no further action shall be taken. If, after an investigation, the department determines that there is no error, the department shall determine the effect on the applicant’s or recipient’s case and take appropriate action. Written notice of the department’s action shall be given to the applicant or recipient.
(e) If the applicant or recipient agrees with the findings of the match between the applicant’s or recipient’s social security number and one or more databases or information tools listed under this section, the department shall determine the effect on the applicant’s or recipient’s case and take appropriate action. Written notice of the department’s action shall be given to the applicant or recipient. In no case shall the department discontinue medical assistance coverage as a result of a match between the applicant’s or recipient’s social security number and one more databases or information tools listed under this section until the applicant or recipient has been given notice of the discrepancy and the opportunity to respond.
(f) The applicant or recipient have an opportunity for a fair hearing in the event of any adverse action affecting eligibility for assistance under this chapter or RSA 161.
VII. The department may contract with third party entities to perform the review of such enrollees as authorized under this section or to provide information to facilitate such reviews.
VIII. The department shall, pursuant to RSA 541-A, adopt any rules necessary to implement this section.
2 Department of Heath and Human Services; Sean William Corey Program. The department of health and human services shall implement, as soon as practicable, the Sean William Corey pilot program established in 2011, 224:298. The program shall be funded within existing appropriations to the department of health and human services subject to approval from the Centers for Medicare and Medicaid Services.
3 Certificate of Need; Nursing Home Beds; Rehabilitation Beds; Moratorium Extended. Amend RSA 151-C:4, III(a) to read as follows:
III.(a) No new certificate of need shall be granted by the board for any nursing home, skilled nursing facility, intermediate care facility, or rehabilitation facility from the effective date of chapter 310, laws of 1995, department of health and human services reorganization act, through the period ending June 30, [2012] 2014. This moratorium shall also apply to new certificates of need regarding any rehabilitation bed in any type of facility, including rehabilitation hospitals and facilities offering comprehensive rehabilitation services. However, a certificate of need shall be issued for replacement or renovation of existing beds as necessary to meet life safety code requirements or to remedy deficiencies noted in a licensing inspection pursuant to RSA 151 or state survey and certification process pursuant to titles XVIII and XIX of the Social Security Act. In addition, a certificate of need may be issued for construction or renovation as necessary to repair or refurbish an existing facility, or to accommodate additional beds obtained by transfer to an existing facility. In the case of repair, refurbishment, or transferred beds, the resulting costs in excess of the current capital expenditure threshold as adjusted for inflation pursuant to RSA 151-C:5, II(f)(1) shall not be reflected in any state Medicaid rate. Any application for a certificate of need under this subparagraph shall indicate whether it is for a life safety code requirement or to remedy deficiencies noted in a licensing inspection or whether it is for repair or refurbishment of an existing facility or for transferred beds. If the application is approved, it shall be deemed that the board has agreed with the indicated reason for such application.
4 Effective Date.
I. Section 1 of this act shall take effect 6 months after its passage.
II. The remainder of this act shall take effect upon its passage.
LBAO
12-2795
Amended 05/03/12
HB 1658 FISCAL NOTE
AN ACT establishing an income and identity verification system for public assistance recipients; relative to implementation of the Sean William Corey pilot program; extending the moratorium on nursing home beds and rehabilitation beds; and repealing assessments for excess benefits paid by employers in the retirement system.
FISCAL IMPACT:
The Department of Health and Human Services, the New Hampshire Association of Counties and the New Hampshire Municipal Association state this bill, as amended by the House (Amendment #2012-1376h), will have an indeterminable fiscal impact on state revenue, and state and local expenditures in FY 2012 and each year thereafter. There will be no fiscal impact on local revenue, or county revenue or expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill requires electronic cross matches of information for applicants of all state welfare programs. The cross matches are required upon application, reapplication, recertification, and re-determination of eligibility for benefits. Current caseloads for these programs are as follows:
Medicaid: 75,047
Long Term Care: 4,503
Medicaid for Employed Adults with Disabilities (MEAD): 1,875
TANF Medical Assistance: 42,806
Financial Assistance to Needy Families (FANF): 7,477
Aid to the Permanently and Totally Disabled (APTD): 8,664
Old Age Assistance: 1,410
Aid to the Needy Blind: 169
Food Stamps: 56,464
Child Care: 4,019
The Department indicates each program has different resource, income, and medical requirements. Some requirements are determined by federal law and some by state law. Each program also requires applicants to re-establish eligibility periodically, ranging from every 6 months to every 2 years. The Department states it receives thousands of applications and re-certifications each month and requires verification of information to be provided by applicants. The Department undertakes routine cross-matches with various state and federal agencies to verify information provided by applicants. These include:
• Memorandum of Understanding (MOU) with the New Hampshire Department of Employment Security providing access to verify data on employment and unemployment benefits. The annual cost of this MOU is $64,200;
• Various cross matches with the U.S. Social Security Administration to verify citizenship, accuracy of social security numbers, and status of benefits administered by the Administration. This cross match is provided at no cost to the Department; and
• Electronic asset cross match of public databases performed by a private company for applicants of long-term care Medicaid benefits. The annual cost of this contract is $5,000.
The Department states many applications are denied based on the self-reported information or for failure of the applicant to provide required verifications. The Department further states it denies far fewer applications and re-certifications based on the data cross matches with state and federal agencies.
The Department is not able to estimate the potential savings to the state general fund, but assumes most of the savings will occur in the Food Stamp and TANF cash assistance programs. Benefits under the Food Stamp program are paid with federal funds and most of the TANF cash assistance payments are also made with federal funds. Under Medicaid managed care any savings would be both state general funds and federal funds.
The Department is not able estimate the additional expenditures associated with the electronic cross matches, but has identified the following areas of cost:
• Cost of performing the electronic cross matches internally or paying an outside vendor to perform the cross matches;
• Additional field investigations to audit discrepancies between applicant information and the public databases;
• Additional workload for eligibility workers who would be required to ensure each cross-match identified in the bill is performed for every application and re-certification;
• Additional workload for eligibility workers to review information received from the cross matches, determine if the information conflicts with the applicant provided information, and determine if the information affects eligibility; and
• Pre-eligibility cross matches will likely impact the timeliness of application processing. Delays in processing applications could result in federal sanctions or possible lawsuits.
The Department indicates not all of the information from the cross matches will have an effect on the applicant’s eligibility for benefits; for example certain programs such as Healthy Kids and Food Stamps do not require a resource test. In addition, information in the databases may not reflect recent changes such as if an applicant has recently relocated to New Hampshire. The Department requires current documentation of residence which would be more reliable than a cross match which revealed an out-of-state driver’s license. Based on a federally mandated quality assurance audit of the food stamp program the error rate in the program is less than 4.5%. The Department states less than one-half of the errors were due to undisclosed client information and not all lacks of disclosure constituted fraud. Therefore, the Department assumes a cross match would identify errors in the food stamp program at a rate of less than 2 percent.
The Department of Health and Human Services states the bill requires the Department to implement a Medicaid waiver for a three-year pilot program for up to 10 children who are medically fragile or have a chronic illness. The Department indicates the program is capped at $25,000 per year per child and, if the Medicaid waiver is approved by the Centers for Medicare and Medicaid Services (CMS), the total annual cost of up to $250,000 would be funded 50% with state funds from the Department’s existing appropriations, and 50% from federal Medicaid funds. The Department states, since this provision of the bill is effective upon passage, the program would be funded by state general funds until the waiver is approved by CMS. The Department further assumes if CMS does not approve the waiver the program will still be required and the total cost would be state funds. The Department is not able to determine if there will be savings to existing programs as a result of the pilot program.
The New Hampshire Municipal Association states the bill requires the Department of Health and Human Services to perform certain investigations to determine if applicants are eligible for public assistance. The Association assumes, if the investigations result in determinations that the applicants are not eligible, they may seek and qualify for assistance under local welfare programs which may increase local expenditures. The Association is not able to estimate the amount of a potential increase, but states the bill does not directly require any additional municipal expenditure.
The New Hampshire Association of Counties states this bill will have no fiscal impact on county revenue or expenditures.
The Office of Legislative Budget Assistance states this bill provides for payment pursuant to the Supreme Court order in Chase Home for Children and another v. New Hampshire Division for Children, Youth and Families, of up to $2,600,000 from state general funds savings realized pursuant to the Income Identity and Verification System establish in section 1 of the bill. Federal funds are assumed to be available for the balance of the judgment. In addition, the judgment requires payment of additional interest from November 22, 2011 at a rate of $214.18 per day until paid.