HB1276: HB1276 Community Health, Department of; review information from certain sources to determine and verify eligibility of Medicaid recipients; provide

Currently, some Medicaid eligibility factors in Georgia can be self-attested, meaning a recipient's own statement can be accepted without outside verification. This bill would stop that for income, residency, identity, household composition, and citizenship or immigration status, except where federal law requires otherwise. Instead, applicants would have to consent to having that information checked, and the Department of Human Services would regularly request data from other state agencies (Corrections, Labor, Revenue) and federal agencies (Social Security Administration, IRS, Postal Service, HUD, FBI) to catch changes affecting eligibility. The bill sets schedules for when agencies must start sharing data (mostly by January 1, 2027), requires eligibility redeterminations at least once every 12 months, limits retroactive Medicaid coverage to two months before an application, and requires an annual public report on outcomes like disenrollments and fraud referrals. The Department of Community Health may need to seek federal approval through a state plan amendment or waiver. The law would take effect January 1, 2027.

• Bars self-attestation, meaning an applicant's own unverified statement, for income, residency, identity, household composition, and citizenship or immigration status unless federal law requires otherwise.
• Requires Medicaid recipients to consent to letting state and federal agencies share their information with the Department of Human Services for eligibility checks.
• Sets up regular data submissions from the Department of Corrections, Department of Labor, and Department of Revenue on schedules ranging from monthly to annual.
• Directs the department to request data monthly and annually from federal agencies like the Social Security Administration, IRS, and FBI to spot eligibility changes.
• Requires eligibility redeterminations at least every 12 months and immediate removal or suspension of recipients confirmed dead, incarcerated, or fleeing felons.
• Limits retroactive Medicaid coverage to no more than two months before an application is submitted, with an exception for continuous coverage.

Medicaid recipients and applicants in Georgia, the Department of Human Services and Department of Community Health, and state agencies including the Department of Corrections, Department of Labor, and Department of Revenue, which must share recipient data under new deadlines.

Georgians on Medicaid would face more frequent, automated checks of their income, residency, and other status using government databases rather than their own word, which could speed up detection of ineligibility but also increase the chance of disenrollment based on data matches, including for people confirmed incarcerated or deceased.

• New Code Section 49-4-200 bans self-attestation for five eligibility factors and requires recipient consent to information disclosure, except where federal law requires otherwise.
• Code Section 49-4-201 directs the Department of Community Health and Department of Human Services to jointly request eligibility data covering identity, death, employment, lottery winnings, residency, incarceration, and assets.
• Code Section 49-4-203 requires the Department of Corrections to report monthly, and the Department of Labor and Department of Revenue to report quarterly or annually, starting no later than January 1, 2027.
• Code Section 49-4-204 requires monthly data requests to federal agencies like the Social Security Administration, HHS, USPS, HUD, and FBI, and annual requests to the IRS, with full implementation deadlines of January 1, 2027 and October 1, 2029 for certain data.
• Code Section 49-4-205 requires eligibility redeterminations at least once every 12 months for all Medicaid recipients.
• Code Section 49-4-206 requires immediate removal of deceased recipients and immediate suspension of recipients confirmed as fleeing felons or incarcerated.
• Code Section 49-4-207 limits retroactive Medicaid eligibility to no more than two months before an application is submitted.
• Code Section 49-4-208 requires an annual report to state leaders on eligibility changes, removals, fraud referrals, costs, and savings, starting January 31, 2027.

1. 2026-03-04House Withdrawn, Recommitted (House)
2. 2026-02-26House Committee Favorably Reported By Substitute (House)
3. 2026-02-17House Second Readers (House)
4. 2026-02-12House First Readers (House)
5. 2026-02-11House Hopper (House)

• Mark Newton (R, HD-127)Primary sponsor
• Chuck Efstration (R, HD-104)
• Lee Hawkins (R, HD-027)
• Sharon Cooper (R, HD-045)
• Darlene Taylor (R, HD-173)

• Medicaid eligibility
• public assistance verification
• state agency data sharing
• health care fraud prevention