From: Government Health IT
Anthony Brino, Associate Editor
Now that the Department of Health and Human Services is giving states until mid-December to make their health insurance exchange decisions, state regulators are hoping to navigate a few HIX uncertainties as they offer policy advice to lawmakers.
The National Association of Insurance Commissioners (NAIC) is putting together an open list of HIX questions for HHS. Among several dozen funding, insurance and regulatory issues, some NAIC members are wondering whether states that are jointly running exchanges with HHS will have to link their IT and administrative systems to the Federally Managed Data Services Hub, which is being developed for HIX, Medicaid and CHIP programs as a verification IT system linking state and federal agencies with consumers.
The NAIC is asking: “If yes, will HHS charge a state to access the hub, and how much? If no, will HHS guarantee that a state will never face a charge to access the Federal Data Hub?”
While it’s not clear how intimately state agencies will have to connect to the data hub, it appears that states have to connect, regardless of whether the HIX is state-based, a partnership or federally-facilitated and regardless of whether the state expands Medicaid. In a recent FAQ, the Centers for Medicare and Medicaid Services says that exchanges and Medicaid agencies will not be charged to use the data hub, and outlines a number of technical details for state health and IT officials.
Many consumers, especially those buying subsidized insurance, will also be using the federal data hub, perhaps via state programs. Set to launch in October 2013, the hub is meant to be a streamlined application and eligibility system for people buying health plans through state exchanges and for people applying for public health plans like Medicaid and CHIP.
CMS says that when it launches next year, the hub will be able to verify Social Security Number identity, citizenship, income information, tax credit eligibility and public minimum essential coverage eligibility.
CMS is offering states the Collaborative Application Lifecycle Tool (CALT), as a way for state agencies to link their Medicaid eligibility and enrollment systems with the federal hub. Some states that are using inefficient legacy IT and administrative systems may find them ripe for an upgrade. Illinois is building a cloud-based Medicaid IT system tha will be integrated with other public assistance programs and will also be part of a health information exchange, and Oklahoma also has one of the more advanced Medicaid systems, with an online enrollment system.
[See also: Why HIX and Medicaid are now on the forefront of national healthcare]
The hub will eliminate the need for states to establish different security requirements, service-level agreements and data use agreements to accommodate different agencies. State exchanges and Medicaid agencies may have to coordinate consumer portals with the federal data hub, using APIs.
The Maryland-based health IT firm QSSI is building the federal data hub, and has begun some testing with Massachusetts and Maryland, two early HIX adopters.
Some of the federal data hub services will function as atomic, or separate uses, and some will function as composite services. CMS officials are still determining the best ways to batch and bulk data transactions in the hub. CMS said in its FAQ that there’s “a need to establish both web services and possibly alternate interfaces to meet batch and bulk data transaction requirements.”
Here’s the rest of CMS’s update on exchange and Medicaid policy.
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