The CMS intends to permanently boost funding that helps states build Medicaid eligibility and enrollment systems.
In 2011, the CMS raised the matching rate to 90% from 50% for money that states spend on building eligibility and enrollment systems and to 75% from 50% for maintenance and operations of those systems. The bump in funds was set to expire in December 2015. The CMS estimated at the time that the enhanced funding would cost the federal government $1.1 billion over the four-year period.
The agency now plans to issue regulations making the bump permanent, according to an Oct. 28 letter (PDF) sent to the National Association of Medicaid Directors and others.
“The department has determined that three years was not a sufficient amount of time to conduct a robust procurement process, planning, systems builds, testing, implementation and refinements that are needed to achieve full systems transformation,” a CMS spokeswoman told Modern Healthcare. “If we do not signal this decision, states may be forced to make decisions to scale back, or de-scope, plans for work that did not get completed during the original timeframes that they established.”
The announcement comes three months after the CMS flagged six states for ongoing technical and administrative woes that have delayed Medicaid access: Alaska, California, Kansas, Michigan, Missouri and Tennessee.
The extra funding is critical, said Tricia Brooks, a researcher at Georgetown University's Center for Children and Families. The states that are furthest behind in updating their eligibility systems are ones with conservative leaders who oppose the Patient Protection and Affordable Care Act, Brooks said, and the one likely to benefit most is Tennessee.
Tennessee was sued this year over long delays faced by applicants for its Medicaid program, TennCare.
State officials in Tennessee said they are thrilled with the CMS announcement.
“We appreciate the administration's decision to continue the 90% match rate,” TennCare spokeswoman Kelly Gunderson said. “It is helpful in the construction of these complex computer systems.”
The extension was also welcomed in Alaska, where funding has allowed the Medicaid program to “upgrade decades-old systems,” said Margaret Brodie, director of the Division of Health Care Services within the Alaska Department of Health and Social Services.
The CMS is also extending a waiver that allows some of the matching funds to be used to link the Medicaid eligibility systems with other human services programs such as the Supplemental Nutrition Assistance Program.
Because most states now have modernized eligibility systems up and running, many will now use the enhanced match to better integrate their systems with other state programs, said Matt Salo, executive director of the National Association of Medicaid Directors.
Follow Virgil Dickson on Twitter: @MHvdickson
