HB 1156 — An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, further providing for verification of eligibility.

PRINTER'S NO.   1283

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1156
                                               Session of
                                                 2025

     INTRODUCED BY HAMM, PICKETT, STENDER, SCIALABBA, KAUFFMAN,
        JAMES, CUTLER, ZIMMERMAN, GROVE, FLICK, BARTON, GLEIM,
        ARMANINI AND FRITZ, APRIL 7, 2025

     REFERRED TO COMMITTEE ON HUMAN SERVICES, APRIL 7, 2025


                                    AN ACT
 1   Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
 2      act to consolidate, editorially revise, and codify the public
 3      welfare laws of the Commonwealth," in public assistance,
 4      further providing for verification of eligibility.
 5      The General Assembly of the Commonwealth of Pennsylvania
 6   hereby enacts as follows:
 7      Section 1.    Section 441.9 of the act of June 13, 1967
 8   (P.L.31, No.21), known as the Human Services Code, is amended by
 9   adding subsections to read:
10      Section 441.9.    Verification of Eligibility.--* * *
11      (d)   The following apply regarding gambling winnings:
12      (1)   The department shall enter into a data matching
13   agreement with the Pennsylvania Gaming Control Board to identify
14   individuals with gambling winnings of three thousand dollars
15   ($3,000) or more.
16      (2)   On at least a monthly basis, the department shall review
17   the information under paragraph (1) and close the case for
18   individuals who are ineligible for medical assistance based upon
 1   verification of the winnings specified under paragraph (1).
 2      (3)     An individual who has failed to disclose the winnings
 3   specified under paragraph (1) and has been identified through
 4   the database match shall be deemed to have presumptively
 5   committed an intentional violation of the medical assistance
 6   program.
 7      (e)     On at least a monthly basis, the department shall
 8   receive and review information from the Department of Health
 9   concerning individuals enrolled in medical assistance that
10   indicates a change in circumstances that may affect eligibility
11   for medical assistance, including death records.
12      (f)     On at least a quarterly basis, the department shall
13   receive and review information from the Department of Labor and
14   Industry concerning individuals enrolled in medical assistance
15   that indicates a change in circumstances that may affect
16   eligibility for medical assistance, including changes in
17   employment or wages.
18      (g)     On at least a monthly basis, the department shall review
19   information concerning individuals enrolled in medical
20   assistance that indicates a change in circumstances that may
21   affect eligibility for medical assistance, including potential
22   changes in residency as identified by out-of-State electronic
23   benefit transfer (EBT) transactions.
24      (h)     On at least a monthly basis, the department shall
25   receive and review information from the Department of
26   Corrections concerning individuals enrolled in medical
27   assistance that indicates a change in circumstances that may
28   affect eligibility for medical assistance.
29      (i)     On at least a quarterly basis, the department shall
30   receive and review information from the Department of Revenue

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 1   concerning individuals enrolled in medical assistance that
 2   indicates a change in circumstances that may affect eligibility
 3   for food stamps, including potential changes in income, wages or
 4   residency as identified by tax records.
 5      (j)   The department shall not accept eligibility
 6   determinations for medical assistance from a health insurance
 7   exchange established in this Commonwealth under 42 U.S.C. §
 8   18041(c) (relating to state flexibility in operation and
 9   enforcement of Exchanges and related requirements). The
10   department may accept assessments from the exchange but shall
11   verify eligibility and make eligibility determinations.
12      (k)   If the department receives information concerning an
13   individual enrolled in medical assistance that indicates a
14   change in circumstances that may affect eligibility for medical
15   assistance, the department shall review the individual's case.
16      (l)   The department may execute a memorandum of understanding
17   with any other State department, agency or division for
18   information required to be shared between entities specified in
19   this section.
20      (m)   Nothing in this section shall prohibit the department
21   from contracting with one or more independent vendors to provide
22   additional data or information that may indicate a change in
23   circumstances that may affect eligibility for medical
24   assistance.
25      (n)   Unless required under Federal law, the department may
26   not:
27      (1)   Designate itself as a qualified health entity for the
28   purpose of making presumptive eligibility determinations or for
29   any purpose not expressly authorized by State law.
30      (2)   Accept self-attestation of income, residency, age,

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 1   household composition, caretaker or relative status or receipt
 2   of other coverage without verification prior to enrollment.
 3      (3)   Request authority to waive or decline to periodically
 4   check any available income-related data sources to verify
 5   eligibility.
 6      (4)   Request authority to waive or decline to comply with
 7   public notice requirements applicable to proposed changes to the
 8   state plan in accordance with 42 CFR 440.386 (relating to public
 9   notice), 447.205 (relating to public notice of changes in
10   statewide methods and standards for setting payment rates) and
11   447.57 (relating to beneficiary and public notice requirements).
12      Section 2.   This act shall take effect in 60 days.




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