Medicaid Eligibility systems get more funding from CMS

States systems are getting further Medicaid funding to address eligibility access.

Last month, the Centers for Medicare & Medicaid Services (CMS) instituted changes designed to help Medicaid improvement efforts across the country. According to HealthcareITNews, Medicaid Management Information Systems will see their federal funding increase by 40 percent thanks to a ruling that builds off of a regulation from five years ago. The source says that this move will lead to greater focus on efficiency as systems are automated.

The newly decided regulations, which took effect on January 1, targeted multiple aspects of interacting with Medicaid, including eligibility processes and the Medicaid Management Information Systems.

Medicaid Management Information Systems will see their federal funding increase by 40 percent.

The text of the official document denoting the change states that there is still necessary work to be done to maximize automation. It also responded to 54 public comments from earlier this year, including those concerning "aligning regulation with modern standards" and updating claims system definitions.

"Without recognition as an integral part of such systems, and without ongoing enhanced federal funding, state Medicaid E&E systems are likely to become out of date and would not be able to coordinate with, and further the purposes of, the overall mechanized claims processing and information retrieval systems," the document read. It also stated that changes to state systems were originally expected "well before December 31." 

As payment reform and other changes are enacted, providers can follow CMS protocol more closely with professional consultants performing advisory tasks. These include clinical documentation auditing and risk assessments as necessary, with the consultants keeping organizational objectives in mind during the whole time. LW Consulting can also assist in developing a compliance plan, which we can then review for effectiveness.

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