Feds Seeking State Innovators to Develop Insurance Exchange IT Systems

Written by Kathy Witgert, Program Manager, NASHP
Last week, HHS announced a new competitive funding opportunity for states to develop IT systems to support the new health insurance exchanges. Up to five states or coalitions of states will receive “Early Innovator” grants to lead the development of IT systems for health insurance exchanges. The goal is to create simple, consumer-oriented systems that allow individuals, families and businesses to sign up for health insurance. The “Early Innovator” states will build universally essential “modules” to administer eligibility, enrollment, premium tax credits, and cost-sharing that can then be adopted and tailored by other states.
Some states have recently launched, or are in the midst of developing, modern eligibility and enrollment systems for Medicaid and CHIP. Their experience will serve them and others well as states prepare to expand existing or build new systems for eligibility and enrollment in their exchanges. Below are a few recent examples and links to more information:

• The Robert Wood Johnson Foundation’s MaxEnroll program, directed by NASHP, has hosted two webinars in recent months focusing on the use of technology to ease enrollment. In May, a webinar featured Virginia’s use of data matching with the Social Security Administration to verify citizenship, and in September, a second webinar highlighted the use of e-signatures.
• Kansas recently released an RFP for a new Medicaid eligibility and enrollment system. The RFP states that this new system will likely serve as the single point of entry for the insurance exchange as well. In addition, the specifications call for a system to be built in modules so that determinations for other social services can be added in the future.
• At NASHP’s annual conference, Richard Evans of the Oklahoma Healthcare Authority shared insights gained from launching an online enrollment system for the state’s Medicaid program. The SoonerCare online enrollment system launched this fall, with goals that include easing the enrollment process for applicants, increasing efficiency for state workers, and allowing applications for multiple programs through one system.
• Wisconsin has shared their extensive experience with their online Medicaid eligibility and enrollment system, known as ACCESS, on a series of webinars sponsored by SHADAC. Thefirst, originally broadcast last summer, provides a tour of the state’s ACCESS application process from beginning to end from the perspective of a single applicant. The second, broadcast live on October 13, 2010, features Melissa Henderson and Jim Jones from Wisconsin’s Department of Health Services, who provide an in-depth presentation and virtual tour of Wisconsin’s eligibility and enrollment system. You can also view Jim Jones’ NASHP conference presentation about ACCESS on the State Refor(u)m website.

Does your state have an RFP for an eligibility system that would be helpful for others? Does your state have other eligibility and enrollment resources related to health reform? Share your resources with us at www.statereforum.org.
Update: Nov. 5, 2010: CMS and the Office of Consumer Information and Insurance Oversight have issued initial technical guidance that will help States decide how they will design, develop, and implement new or improved IT systems for the new health insurance Exchanges, Medicaid and CHIP. The guidance is available here. CMS has also issued a proposed rule that would raise the FMAP for Medicaid management information system improvements to 90% if certain conditions are met. Access the proposed rule here. If your state submits comments, please consider also sharing them with us at statereforum@oldsite.nashp.org.