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HHS rule would increase federal matching funds for health exchanges, Medicaid technology

NEWS IN BRIEF — Posted Nov. 15, 2010

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The Dept. of Health and Human Services on Nov. 3 released a proposed rule to provide enhanced federal matching rates to develop and operate systems that would determine Americans' eligibility for Medicaid, the Children's Health Insurance Plan and subsidized coverage in health insurance exchanges.

The national health reform law requires health insurance exchanges -- run by states or the federal government -- to be operational in 2014. The exchanges will offer private health plans with financial assistance for individuals earning up to 400% of the federal poverty level, or $43,320, and enroll people who are eligible for Medicaid or CHIP.

"Individuals will seek health care coverage without necessarily knowing whether they are looking for an exchange plan, a Medicaid or a CHIP plan," said Joel Ario, director of the HHS Office of Health Insurance Exchanges.

The proposed rule would increase the federal share of creating new systems to determine eligibility and enroll citizens in Medicaid to 90%. That's up from the typical 50% for Medicaid administrative spending. The rule would hike the federal share of operating these systems to 75%. The 90% enhanced match for new systems would be available until Dec. 31, 2015, while the 75% match would be available even longer if the system continues to meet federal standards. States must seamlessly integrate the Medicaid and health insurance exchange eligibility systems. HHS is accepting comments on the proposed rule through Jan. 7, 2011.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2010/11/15/gvbf1115.htm.

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