NESCSO helps State agencies improve the effectiveness of publicly funded health and human services by investing in State employees

NESCSO helps State agencies improve the effectiveness of publicly funded health and human services by investing in State employees

NEW! 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 Elena.Nicolella@nescso.org

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.

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, an APD Journey Map Workgroup and an Interoperability Workgroup (see below for more information). 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: Brandon Lewis, WV

Immediate Past State Co-Chair: PJ Fritsche, TX

Members:     David Whitham, MA

Christine Nolan, WA

Joe Graves, TX

Maik Schulze, KY

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 David.Huffman@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:

S-TAG Primer on Patient Access API vSept212020

Draft RFP Language

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)

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.

The 2021 MESC will be in Boston, MA from August 9 to 12.  For more information, please visit www.mesconference.org