Final Rule:Mechanized Claims Processing and Information Retrieval Systems (90/10)

Today the Centers for Medicare & Medicaid Services (CMS) issued a final rule on the Extension of 90/10 Federal Funding for Medicaid Eligibility Systems. The final rule is a key piece of CMS’ efforts to support states in modernizing state eligibility systems to make real time, accurate eligibility determinations and promote enrollment of eligible low income people in Medicaid and CHIP.

These changes will support states in developing more efficient Medicaid eligibility and enrollment systems, as well as Medicaid Management Information System (MMIS) claims systems, through initiatives such as automating the application and renewal process, processing claims more efficiently, integrating with human services programs, retiring outdated legacy systems, and enhancing program reporting and management tools to support program integrity.

Additional information on the rule at the Federal Register click here (PDF): https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-30591.pdf  and available online athttp://federalregister.gov/a/2015-30591 (on 12/04/2015 ).

For more information, including summaries of key provisions of the final rule, visit

http://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/data-and-systems.html