HHS Issues IT Exchange Guide

The Health and Human Services Department this week issued preliminary technical guidelines for health IT systems that will support state insurance exchanges slated to become operational in 2014. The information will help states decide what health IT systems they need to facilitate the exchanges and to administer Medicaid and the Children's Health Insurance Program (CHIP), as well.

"By providing a place for one-stop shopping, exchanges will make purchasing health insurance easier and more understandable -- and consumer-friendly IT infrastructure will be critical to their success," HHS said on its website. The IT guidance is designed to make IT systems "simple and seamless in identifying people who qualify for tax credits, cost-sharing reductions, Medicaid or ... CHIP."

The announcement came the morning after the midterm election, the results of which put the future of the insurance exchanges in doubt. They were authorized under the Affordable Care Act that Rep. John Boehner of Ohio, the presumed next Speaker of the House, has vowed to repeal under the new Republican majority.

The HHS announcement made no mention of the election or potential threats to the insurance exchanges.

HHS also announced proposed rules for "early innovator" states to secure enhanced federal matching funds for streamlining and updating Medicaid eligibility systems. States would have to meet performance standards to be eligible for up to 90 percent in matching funds for developing the systems and 75 percent for maintenance and operations.

As proposed, the 90 percent match would be available through the end of 2015, the 75 percent match for operations and maintenance beyond that. The current maximum matching rate is 50 percent. The grants would support related IT infrastructure and go to states "that demonstrate leadership in developing cutting-edge and cost-effective consumer-based technologies and models for insurance eligibility and enrollment for exchanges," according to an HHS news release.

"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, deputy administrator of the Centers for Medicare and Medicaid Services and director of the Center for Medicaid, CHIP and Survey & Certification.