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Healthcare Business News

CMS now transmitting Medicaid applications from to some states

By Virgil Dickson
Posted: December 16, 2013 - 5:00 pm ET

The CMS now has at least some ability to transmit completed Medicaid applications to state agencies from, the federal government's online portal for enrolling in new coverage under the healthcare reform law.

As of Monday, the CMS said, 10 states were receiving full data transmissions: Alabama, Delaware, Idaho, Nebraska, New Hampshire, New Mexico, Montana, Pennsylvania, Tennessee and West Virginia. They represent less than a third of the 36 states that are not operating health insurance exchanges and are relying on the federal marketplace to either assess or determine Medicaid eligibility for applicants who apply for coverage at

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For nearly three months, since the Oct. 1 start of open enrollment, the site has not been able to transmit applications for eligible applicants to state agencies. As a stopgap measure, the CMS has been sending weekly data transmissions to state Medicaid officials with limited information about individuals who have been tentatively deemed eligible for the program.

These transmissions, known as “flat files,” were never meant to be used to enroll anyone, according to the CMS. Rather, they were meant to prepare agencies for the work of sorting through new enrollees. States, however, have complained that those files are often riddled with errors. For example, some have received data on people that are already enrolled in Medicaid, and others that don't live in the state.

The 10 states began to get the completed applications this past weekend, according to a memo that the National Association of Medicaid Directors prepared for members.

Federal officials will gradually increase the transfer of the files rather than send the backlog in a single batch in order to make sure the connection with remains stable, the CMS told state officials.

Other states are still working on coding and systems updates to accommodate the automatic transfers, and others are pursuing the waivers to use the “flat files” to enroll beneficiaries, a workaround the CMS outlined last month.

A representative from the CMS declined to predict when all 36 states relying on the federal portal would receive the automatic electronic transfers.

Follow Virgil Dickson on Twitter: @MHvdickson

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