Dive Brief:
- CMS has proposed to make the 2011 boost in matching rates to help states build and maintain Medicaid eligibility and enrollment systems permanent.
- The higher rates, up 40% for building eligibility and enrollment systems and 25% for maintenance and operations, were set to expire in 2015.
- It was originally estimated that the higher rates would cost the federal government $1.1 billion over the four-year period (2011 through 2015). It is now estimated that the proposed regulation will cost an additional $3 billion for the years 2016 through 2025.
Dive Insight:
"We believe that most states have not had sufficient time to complete the total system replacement for … eligibility functionality," CMS said in a proposed rule. "Without ongoing enhanced federal funding, state Medicaid eligibility and enrollment systems are likely to become out of date and would not be able to coordinate with, and further the purposes of, the overall mechanized claims processing and information retrieval systems."