This blog was authored by Tricia Brooks, a Senior Fellow at the  Center for Children and Families at Georgetown University. It originally appeared on November 4th on Say Ahhh! A Children’s Health Policy Blog and is cross-posted here with permission. For prior blog posts on health care reform and additional resources, click here

I’m not big on rules. When I ran New Hampshire’s Children’s Health Insurance Program  and had to talk with a family who was unhappy about some bureaucratic rule, I often diffused the conversation by saying “I don’t make the rules, if I did there wouldn’t be any.” I know, that was a cop-out but it worked. Now I take those words back. This is one rule I might love!

The Centers for Medicaid & Medicare Services (CMS) has published a proposed rule in the federal register that would broaden the definition of “claims” to include “claims of eligibility” in regard to Medicaid management information systems. What does this really mean? It means that eligibility systems may qualify (assuming the rule is adopted) for a 90 percent federal financial participation to support the design, development, testing and implementation of new or enhanced eligibility systems capacity through 2015. Systems could also qualify for an ongoing 75 percent federal match once they are operational.

Is this a big deal? Indeed it is. States have been severely encumbered by a lack of resources to make system innovations or replace decades old legacy systems that, quite frankly, have outlived their usefulness due to a lack of major overhauls. Moving forward on streamlining efficiencies and the use of data matching to verify eligibility helps both states and real people but requires the latest in systems architecture and performance to achieve the innovations that we know are possible. These kinds of system transformations, along with seamless integration with Exchange IT systems, require major investments and the enhanced federal funding will be welcome news to cash-strapped states. Read the rest of this entry »

This is the second of what will be an ongoing series of posts looking at the impact of the new federal health care reform law on Oklahoma and Oklahomans. The first looked at how reform will mitigate the public benefits “cliff effect”. For full information on health care reform, the Henry J. Kaiser Family Foundation website is excellent.We encourage your contributions as comments or as  a guest blog.

The passage of the new federal health care law represents a monumental shift in the nation’s health care delivery system that will unfold over the coming years. States and state governments will be effected by the new law in myriad ways, only some of which are recognized at this early stage. One issue that has caused some concern for state governments, particularly in the context of the deep and prolonged state fiscal crisis, is the obligation that states will eventually be asked to assume for a portion of the cost of covering the newly insured.

With the passage of health care reform, the Oklahoma Health Care Authority has estimated that an additional 250,000 Oklahomans will be newly qualified for Medicaid, the nation’s primary health insurance program for the poor, jointly financed by the federal and state governments.  Under the law, all working-age  adults with household incomes up to 133 percent of the federal poverty level – around $24,000 for a family of three in 2009 – will become eligible for Medicaid effective in 2014.  Read the rest of this entry »