42 U.S.C. § 1396w — Asset verification through access to information held by financial institutions

(a) Implementation. (1) Subject to this section, every State must implement the asset-verification program in (b) to determine or redetermine a person’s Medicaid eligibility. (2) Each State must (A) submit, by a Secretary-set deadline consistent with (3), a plan amendment explaining implementation, and (B) implement the program for determinations and redeterminations made six months after that submission deadline. (3)(A)(i) California, New York, and New Jersey, which had an asset-verification program before June 30, 2008, must implement one by the end of fiscal year 2009. (ii) The Secretary must require other States to submit and implement programs so that, together, the programs apply to approximately, but at least, 12.5 percent of enrollees by the end of fiscal year 2009, 25 percent by 2010, 50 percent by 2011, 75 percent by 2012, and 100 percent by 2013. (iii) Puerto Rico must implement one by January 1, 2026. (B) In selecting other States, the Secretary must consult them and consider feasibility. (C) The specified prior States are California, New York, and New Jersey. (D) A State may ask for, and the Secretary may approve, earlier implementation. (4) This section applies only to the 50 States, the District of Columbia, and Puerto Rico. (b) Asset-verification program. (1) It is a program in which a State (A) requires each applicant or recipient qualifying because aged, blind, or disabled to authorize the State, at no cost to that person, to obtain from any financial institution any financial record held about the person, and about another person whose resources the law requires disclosed, whenever the State finds the record needed to decide eligibility, amount, or extent of assistance. The State is subject to the Right to Financial Privacy Act cost-reimbursement rule in section 1115(a), 12 U.S.C. 3415. (B) The State uses the authorization to verify financial resources and decide or redetermine eligibility. (2) The program must verify individual assets consistently with the approach used by the Social Security Commissioner under section 1383(e)(1)(B)(ii). (c) Authorization duration. Despite 12 U.S.C. 3404(a)(1), authorization remains effective until the earliest of (1) a final adverse decision on the application, (2) the recipient stops being eligible, or (3) the applicant or recipient, or other applicable person, expressly revokes it in written notice to the State. (d) Right to Financial Privacy Act. (1) State authorization is treated as satisfying that Act for section 3403(a) and need not be given to the financial institution despite section 3404(a). (2) Section 3403(b) certification requirements do not apply to State requests under the authorization. (3) Such a request is deemed to satisfy section 3404(a)(3) and section 3402’s reasonable-description requirement. (e) Required disclosure. The State must tell each authorizing person the authorization’s duration and scope. (f) Refusal or revocation. If an applicant, recipient, or other applicable person refuses to give or revokes authorization, the State may find the applicant or recipient ineligible on that basis. (g) Contractor. A State may contract with a qualified public or private entity chosen under applicable contracting rules and section 1396b(i)(2). The contractor has the same information-use and disclosure limits as the State. (h) Technical help. The Secretary must help States implement the program. (i) Reports. An implementing State must provide reports at the times, in the format, and with the information the Secretary requires. (j) Expenses. Reasonable State program expenses are treated, for section 1396b(a), like expenditures under paragraph (7) of that section. (k)(1) FMAP reduction. For a calendar quarter, the usual FMAP is reduced for a noncompliant 50-State or District of Columbia State by 0.12 percentage points in 2021–2022, 0.25 in 2023, 0.35 in 2024, and 0.5 in 2025 and later. For noncompliant Puerto Rico it is reduced by 0.12 points for fiscal-year 2026 quarters beginning on or after January 1, 2026, 0.25 in fiscal 2027, 0.35 in fiscal 2028, and 0.5 in fiscal 2029 and later fiscal years. (2) “Non-compliant State” means one of those jurisdictions for which the Secretary has not approved the amendment required by (a)(2) and that is not continuously operating a program under this section.