Indiana § 12-15-1-24 - Prohibition on self-attestation without verification; data matching agreements; review of data from other agencies concerning Medicaid recipients

§ 12-15-1-24. Prohibition on self-attestation without verification; data matching agreements; review of data from other agencies concerning Medicaid recipients

Note: This version of section effective until 1-1-2027. See also following version of this section, effective 1-1-2027.

Sec. 24. (a) Except as required under federal law, the office of the secretary may not accept self-attestation of any of the following in the administration of the Medicaid program without verification before enrollment:

(1) Income.

(2) Residency.

(3) Age.

(4) Household composition.

(5) Caretaker or relative status.

(6) Receipt of other coverage.

(b) The office of the secretary shall enter into a data matching agreement with:

(1) the state lottery commission; and

(2) the Indiana gaming commission;

to, on at least a monthly basis, identify individuals receiving Medicaid assistance with lottery and gambling winnings of at least three thousand dollars ($3,000). Upon verification of any winnings resulting in the individual no longer being eligible for Medicaid, the office of the secretary shall terminate the individual's enrollment.

(c) On at least a monthly basis, the office of the secretary shall review vital statistics information provided by the Indiana department of health under IC 16-19-3-19 to determine removal of deceased individuals from Medicaid enrollment.

(d) On at least a quarterly basis, the office of the secretary shall receive and review information from the department of state revenue and the department of workforce development concerning Medicaid recipients that indicates a change in circumstances that may affect eligibility, including changes to employment or wages.

(e) On at least an annual basis, the office of the secretary shall receive and review information from the department of state revenue concerning Medicaid recipients, including:

(1) adjusted gross income; and

(2) family composition;

that indicates a change in circumstances that may affect Medicaid eligibility.

(f) On at least a monthly basis, the office of the secretary shall review information concerning Medicaid recipients who also receive SNAP benefits to determine whether there has been any change in circumstances that may affect Medicaid eligibility, including a change in residency as may be identified through electronic benefit transfer program transactions.

(g) On at least a monthly basis, the office of the secretary shall receive and review information from the department of correction concerning Medicaid recipients that may indicate a change in circumstances that may affect Medicaid eligibility.

(h) Upon receiving information concerning a Medicaid recipient that indicates a change in circumstances that may affect Medicaid eligibility, the office of the secretary shall promptly conduct an eligibility redetermination for the recipient.

As added by P.L.126-2025, SEC.5. Amended by P.L.23-2026, SEC.83.

IC 12-15-1-24Prohibition on self-attestation; data matching agreements; review of data from other agencies; redeterminations Note: This version of section effective 1-1-2027. See also preceding version of this section, effective until 1-1-2027.

Sec. 24. (a) Except as required under federal law, the office of the secretary may not accept self-attestation of any of the following in the administration of the Medicaid program without verification before enrollment:

(1) Income.

(2) Residency.

(3) Age.

(4) Household composition.

(5) Caretaker or relative status.

(6) Receipt of other coverage.

(b) The office of the secretary shall enter into a data matching agreement with:

(1) the state lottery commission; and

(2) the Indiana gaming commission;

to, on at least a monthly basis, identify individuals receiving Medicaid assistance with lottery and gambling winnings of at least three thousand dollars ($3,000). Upon verification of any winnings resulting in the individual no longer being eligible for Medicaid, the office of the secretary shall terminate the individual's enrollment.

(c) On at least a monthly basis, the office of the secretary shall review vital statistics information provided by the Indiana department of health under IC 16-19-3-19 to determine removal of deceased individuals from Medicaid enrollment.

(d) On at least a quarterly basis, the office of the secretary shall receive and review information from the department of state revenue and the department of workforce development concerning Medicaid recipients that indicates a change in circumstances that may affect eligibility, including changes to employment or wages.

(e) On at least an annual basis, the office of the secretary shall receive and review information from the department of state revenue concerning Medicaid recipients, including:

(1) adjusted gross income; and

(2) family composition;

that indicates a change in circumstances that may affect Medicaid eligibility.

(f) On at least a monthly basis, the office of the secretary shall review information concerning Medicaid recipients who also receive SNAP benefits to determine whether there has been any change in circumstances that may affect Medicaid eligibility, including a change in residency as may be identified through electronic benefit transfer program transactions.

(g) On at least a monthly basis, the office of the secretary shall receive and review information from the department of correction concerning Medicaid recipients that may indicate a change in circumstances that may affect Medicaid eligibility.

(h) Upon receiving information concerning a Medicaid recipient that indicates a change in circumstances that may affect Medicaid eligibility, the office of the secretary shall promptly conduct an eligibility redetermination for the recipient.

(i) Unless prohibited by federal law, the office of the secretary shall conduct a Medicaid eligibility redetermination for a recipient as follows:

(1) At least one (1) time every six (6) months for a nonelderly adult Medicaid recipient whose eligibility is determined based upon a modified adjusted gross income standard under 42 CFR 435.603, including adults eligible under 42 U.S.C. 1396u-1.

(2) At least one (1) time every twelve (12) months for any other Medicaid recipient.

As added by P.L.126-2025, SEC.5. Amended by P.L.23-2026, SEC.83; P.L.63-2026, SEC.8.