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The annual Medicaid Enterprise Systems Conference (MESC) introduced day 3 with an interactive session discussing health information technology in the Medicaid enterprise—past, present, and future. If you weren’t able to attend, check out our MESC recap of key takeaways.

HIPAA is more than a privacy law. “HIPAA is one the most impactful laws in Medicaid Enterprise.” While many consider HIPAA as a privacy law, it contains significantly more that directly impacts the Medicaid Enterprise.  HIPAA as we know it today—17 years in the making: 

  • August 1996: HIPAA signed into law 
  • April 2003: HIPAA Privacy Rule Standards for individually identifiable health information 
  • April 2005: HIPAA Security Rule Security Standards to safeguard protected health information 
  • March 2006: HIPAA breach enforcement rule
  • January 2009: HIPAA 5010 and ICD-10 mandate rules insured 
  • September 2009: HITECH and the breach notification rule—accounting for disclosures 
  • March 2013: Final Omnibus Rule GINA Privacy increased penalties for breaches individual access to electronic records 

CMS’ Health IT Specialist John Allison took the audience through a high-level overview of HITECH’s Impact. By the numbers, total Medicaid EHR Incentive payments through August 8, 2018: 465,202 payments to 215,523 providers totaling $13,135,000,048. This equates to a $365,153,257 increase. 

States and industry partners must work together. The plenary: Opportunities for Collaboration Discussion explored different resources and collaborative opportunities that exist for states and Industry Partners to work together to address challenges facing today’s Medicaid Enterprise Systems. “MITA is the language of Medicaid” was the overarching theme of this fast-paced session. The first section dove into defining the MMIS Cohort: a forum for states and CMS to discuss topics such as states’ modular certification experiences and collaboration opportunities.  

Key Activities:

  • Share experiences, challenges, and lessons learned;
  • Identify opportunities to collaborate with one another and/or with CMS; and
  • Hear “sneak peeks” and provide feedback on upcoming CMS initiatives  

This theme was carried through several sessions, including Medicaid Technology Alliance: A multi-sector strategic collaborative where Leavitt Partners’ Principal Ryan Howells took the stage sharing that includes both states and vendors to help advance a State Medicaid program’s business objectives through the use of restful, FHIR-based, Open API’s to achieve better enterprise data liquidity.  Here are some key takeaways:

  • CMS/MITRE transitioned the Project Poplin work to MITA in August 2018 
  • Over the next 1-3 years, short-term opportunities to leverage existing Open API’s from the Commercial and Medicare sectors will be available to assist states
  • Open API’s can help data holders and product vendors better share data with each other through a flexible, open standards-based, reusable architecture to help achieve the goal of the Medicaid program  

States are playing a key role in accelerating Interoperability. MITA-Technical Architecture Committee’s (MITA TAC) Chair David Walsh offered an insightful introduction of the committee, which focuses on Medicaid technology, especially standards and interoperability for the past 15 years.  During the presentation, he shared that a demo of interoperability was developed here at MESC. The final update to MITA 3.0 is being published by CMS.

The 2018 State of the Nation MITA 3.0 presented the results of the 2018 MITA Annual Longitudinal Survey. 2018 marks the 7th year of conducting the survey and is a result of a collaborative effort from state and federal agencies, industry work groups, and the vendor community.  NMEH MITA Co-Chair Jeff Strand  highlighted the modernization strategy and plans to extend the technical capability outside Medicaid. Strand discusses that they are continually updating our system in small portions. In 2017, they implemented a new system, but need to add to the Enterprise due to EVV and more. The system implemented in 2017 provided many updates to maturity. He hopes to have an updated assessment in CY2018. Lastly, he expresses the need to produce a new system which will consist of multiple modules.  

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