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Aneesh Chopra: Federal Database for State Health-Program Eligibility Rules Would Allow for Openness, Innovation

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Photo: span.state.gov
Photo: span.state.gov

A Health and Human Services Department panel has approved a plan to build a federal database of business rules that could help states determine the eligibility of consumers for Medicaid and other federal health insurance programs, Government Health IT reports.

Having all state health-program enrollment data in a one database would also keep states from having to rebuild data sets that have already been compiled elsewhere, said federal Chief Technology Officer Aneesh Chopra.

“That will allow for transparency and innovation over time in eligibility rules,” he said at a policy committee meeting last week.

The exchanges will allow healthcare consumers to compare information on state health-insurance programs such as Medicaid, high-risk pools and other public and private health plans.

One business rule with Medicaid eligibility is that an insurance seeker’s income level must be under a certain threshold of the federal poverty line, Chopra said. Currently, the majority of business rules are not easily known or accessible, and it is hard to understand how some states determine eligibility, he said.

The committee also recommended that states confirm the personal income, citizenship and legal status of health-program applicants.

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