HB 1276: 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 applicants can simply state facts like income or residency without independent verification. HB 1276 would end that practice for income, residency, identity, household composition, and citizenship or immigration status, requiring verification before enrollment except where federal law requires otherwise. The bill sets up ongoing data-sharing between the Department of Human Services, the Department of Community Health, other state agencies (Labor, Revenue, Corrections), and federal agencies like the Social Security Administration, IRS, and FBI to catch changes in circumstances that could affect eligibility. It requires yearly eligibility redeterminations, limits retroactive Medicaid coverage to two months before an application (with exceptions), and requires immediate removal of deceased enrollees and suspension of incarcerated or fleeing-felon enrollees. The Department of Community Health must also submit annual reports to state leaders and may need federal approval through a state plan amendment or waiver. The law would take effect January 1, 2027.

• Bans self-attestation for Medicaid income, residency, identity, household composition, and citizenship or immigration status, requiring verification before enrollment.
• Requires Medicaid applicants to consent to disclosure of their personal information so state and federal agencies can verify eligibility data.
• Directs the Department of Corrections, Department of Labor, and Department of Revenue to regularly submit recipient data (monthly, quarterly, or annually) to the Department of Human Services.
• Requires the department to request data from federal agencies including the Social Security Administration, IRS, HUD, USPS, and FBI to check for eligibility changes.
• Requires eligibility redeterminations at least every 12 months and immediate removal or suspension of deceased, incarcerated, or fleeing-felon recipients.
• Limits retroactive Medicaid coverage to two months before an application is filed, with exceptions required by federal law.

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

Medicaid recipients would face stricter verification requirements and more frequent eligibility checks, which could lead to faster removal of ineligible people but also more paperwork and scrutiny for enrollees. Retroactive coverage for new applicants would shrink from potentially longer periods to just two months.

• New Code Section 49-4-200 bans self-attestation for five eligibility factors and requires applicant consent to data disclosure.
• Code Section 49-4-201 directs coordination between state agencies to gather data on identity, death, employment, lottery winnings, residency, incarceration, and assets.
• Code Section 49-4-203 sets deadlines (starting January 1, 2027) for the Department of Corrections, Labor, and Revenue to submit recipient data on monthly, quarterly, or annual schedules.
• Code Section 49-4-204 requires monthly requests to federal agencies like the Social Security Administration and annual IRS data requests, with phased implementation through October 2029.
• Code Section 49-4-205 requires eligibility redeterminations at least every 12 months for all Medicaid recipients.
• Code Section 49-4-206 requires immediate removal of deceased recipients and suspension of incarcerated or fleeing-felon recipients from Medicaid.
• Code Section 49-4-207 limits retroactive Medicaid eligibility to two months before an application, not affecting ongoing coverage.
• Code Section 49-4-208 requires an annual report starting January 31, 2027 to the Governor and legislative leaders on the program's implementation and effects.

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

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

• Medicaid eligibility
• public assistance
• government data sharing
• healthcare policy
• Medicaid fraud prevention