HHS boosts rate for Medicaid enrollment IT systems

The Health and Human Services Department will increase the Medicaid federal payment rates to states that upgrade their IT systems to create health insurance exchanges for enrollment under the health reform law.

HHS said the Medicaid payment rate for eligible systems would be 90 percent through 2015, up from 50 percent currently, according to a news release dated Nov. 3. After 2015, the rate would be 75 percent.

HHS published a notice of proposed rulemaking in the Federal Register on Nov. 3 describing the new program. States must meet performance standards and conditions to be eligible for the higher rates.

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The goal is to help states implement the Affordable Care Act that establishes health insurance exchanges for enrollment of people who qualify for Medicaid, Children’s Health Insurance Program, tax credits or cost-sharing reductions under the law.

HHS officials also said they would provide guidance to help states design and implement the IT systems for the exchanges. On Oct. 29, HHS said funding would be available to five states that develop model insurance exchange IT systems that other states can copy.

HHS officials said the insurance exchanges must operate seamlessly with links between federal and state systems.

“Individuals will seek health care coverage without necessarily knowing whether they are looking for an exchange plan, a Medicaid or a CHIP plan,” Joel Ario, director of the HHS Office of Health Insurance Exchanges, said in the release.