The Department of Health and Human Services (HHS) has announced 40 percent more funding to support states in streamlining and upgrading their Medicaid eligibility systems and health insurance exchanges.
The proposed rulemaking, published in the Nov. 3 Federal Register allows for Medicaid eligibility systems to receive an enhanced federal matching rate of 90 percent for design and development of new IT systems and a 75 percent federal matching rate for maintenance and operations. This represents a significant increase above the 50 percent match rate currently available for these systems, HHS officials said.
The federal assistance comes as states prepare for increased enrollment in Medicaid and health information exchanges in 2014 as mandated under the Affordable Care Act.
"These prudent, efficient technology investments will support a simple, coordinated, consumer-oriented system for individuals, families and businesses to sign up for the health insurance plan that they choose," according to HHS. "They complement the competitive funding announcement released on Oct. 29, to create cooperative agreements with up to five states to create models for IT infrastructure that all states can use."
As states prepare for 2014, they have requested early guidance and funding assistance for their technology projects, particularly with respect to eligibility and enrollment systems, according to HHS.
"The resources and guidance announced today are an important next step in developing seamless systems of coverage and ensuring effective and efficient implementation of health insurance exchanges and a modernized Medicaid program," said Cindy Mann, CMS deputy administrator and director for the Center for Medicaid, CHIP and Survey and Certification. "Building a smooth customer experience requires a foundation of integrated eligibility systems for health insurance assistance at both the state and federal levels and the resources and guidance announced today supports this foundation."
Joel Ario, director of the Office of Health Insurance Exchanges, said individuals will seek healthcare coverage without necessarily knowing whether they are looking for an exchange plan, a Medicaid or a CHIP plan. "Effective and efficient data exchange between state and federal health programs is critical to achieving this one-stop shopping experience and today's guidance establishes the framework and approach that will make this seamless coordination possible," he said.