National Medicaid Enterprise Systems
In 2020, combined state and federal spending on the technology that supports state Medicaid programs exceeded $22 billion. These systems support all aspects of a Medicaid program, including but not limited to eligibility and enrollment processes; provider enrollment; claims adjudication; third party liability; fraud, waste, and abuse; care management; and data analytics. NESCSO invests our resources in this area because we recognize the importance of effective technology to ensuring high-value Medicaid programs.
Annual Medicaid Enterprise Systems Conference (MESC)
This annual convening brings together representatives from state, territorial, and federal governments and the private sector. NESCSO considers the MESC a natural extension of the work we do for the S-TAG. The MESC facilitates State and Territorial government employees access to new technologies and solutions, enables networking with their government peers as well as with industry representatives. The MESC is also an opportunity for States and Territories to highlight their innovations with their industry partners.
Almost two thousand participants attended the MESC 2023 which was held in Denver, CO, August 21 to 24. The MESC 2024 will be hosted in Louisville, KY August 14 to 18, 2024 and is anticipated to grow in size, scope and value to state agencies throughout the country. For more information, please visit www.mesconference.org
CMS Systems Technical Advisory Group
Successful technology implementation and operation rests on state and territorial government employees responsible for these systems. The Systems Technical Advisory Group (S-TAG) provides these employees a forum to learn from each other and from their federal partners. S-TAG activities include monthly calls with CMS, as well as seven sub-groups addressing:
- Artificial Intelligence
- Certification
- Eligibility and Enrollment
- Health Information Technology
- Interoperability
- Testing
- T-MSIS
The S-TAG enables State and Territorial employees to have a collective voice in response to CMS initiatives. The S-TAG also allows CMS to easily communicate with and gather information from States and Territories on their activities.
The S-TAG is governed by an Advisory Council:
- CMS Co-Chair: Ed Dolly
- State Co-Chair: Mason Tanaka, LA
Members:
- Sandi Oulette, CT
- Mary Arcenas, NJ
- David Levy, RI
- Christopher Ball-Corriere, TX
- Shelley Dimick, VT
- Christine Nolan, WA
NESCSO provides administrative support to the S-TAG at no cost. We schedule monthly calls, develop agendas for review and approval by the Advisory Council, draft meeting minutes, organize the Workgroups, conduct information-gathering efforts and maintain a regularly updated S-TAG directory.
Participation in the S-TAG is limited to State, Territorial, and Federal employees. If you would like more information, please contact Joe.Graves@nescso.org
State Medicaid Interoperability Survey
On behalf of the S-TAG Interoperability Workgroup, NESCSO conducted a brief survey of State Medicaid agencies to better understand how States are implementing the requirements of the Interoperability and Patient Access Final Rule (CMS-9115-F). The survey reflects responses from 34 States on their ability to meet the July 1, 2021 implementation date as well as how States are procuring the services to support implementation.
View the survey here: Interoperability Survey-022521
If you have any questions, please contact info@nescso.org
Interoperability Resources
NESCSO recognizes the potential for this Rule to significantly impact Medicaid programs. For many State agencies, the Final Rule is the first introduction to Fast Healthcare Interoperability Resources (FHIR)-enabled Application Programming Interfaces (APIs), which have the potential to transform the way Medicaid agencies exchange healthcare data. We also recognize that the Rule’s aggressive implementation timeframes may force States to comply quickly and lose this opportunity for thoughtful and strategic digital transformation.
Through NESCSO’s support of a State Interoperability Workgroup, we seek to provide tools, resources, and opportunities for State collaboration so that the full potential of the Rule can be realized.
We have developed the following resources that are publicly available:
Interoperability Workgroup Questions for CMS – November 4, 2020 – Access the questions for CMS by following the link: Interoperability Workgroup-Questions for CMS – November 4, 2020 (Questions for CMS)
Good Faith Exemption Request – November 4, 2020 – Please follow the link to access the request Good Faith Exemption Request – November 4, 2020 (Good Faith Exemption Request Letter)