Section 5163.50
(A) The department of medicaid shall issue one or more requests for information relating to medicaid eligibility data and operations to identify and assess systems and solutions that may be available to improve or augment the management, efficiency, frequency, and accuracy of medicaid eligibility determinations and processing. The requests for information shall include systems and data relating to all of the following:
(1) Medicaid enrollee or applicant identity verification;
(2) Medicaid enrollee death verification;
(3) Employment and wages;
(4) Lottery winnings;
(5) Residency verification including residency relating to concurrent enrollment in medicaid programs in other states;
(6) Household composition;
(7) Medicaid enrollee incarceration status;
(8) Third-party liability verification;
(9) Asset verification;
(10) Any other records or systems the department considers appropriate in order to strengthen program integrity, reduce costs, and reduce fraud, waste, and abuse in the medicaid program.
(B) As part of the considerations under division (A) of this section, the department shall consider augmenting existing vendor arrangements relating to processing and managing medicaid eligibility cases.
(C) The department may procure one or more vendors to implement any solutions identified as cost effective and feasible. Any vendor compensation under this section shall be performance-based.
(D) The department shall prepare and submit a report to the chairpersons of the standing committees in the house of representatives and senate with jurisdiction over medicaid detailing its findings from the requests for information and considerations conducted under this section.
Last updated August 13, 2025 at 10:25 AM
Available Versions of this Section
- September 30, 2025 – Enacted by House Bill 96 - 136th General Assembly [ View September 30, 2025 Version ]