• Date Due: December 15, 2024
  • Author: Department of Medical Assistance Services
  • Enabling Authority: Appropriation Act - Item 292 HH. (Special Session I, 2024)
  • Description:
    Report on the findings and recommendations of the consultant hired by the Department of Medical Assistance Services (DMAS) to perform a systematic review and evaluation of all aspects of Medicaid eligibility determination as performed by DMAS and local Departments of Social Services (LDSS), including: (i) an evaluation of the current information technology systems; (ii) measuring the accuracy, processing times and efficiency of current eligibility determination processes; (iii) determining how well the current structure and systems handle high volumes; (iv) assessing the current level of automation and determining processes that could be streamlined; (v) analyzing the overall cost-effectiveness of how eligibility is conducted, considering staffing costs and ongoing operational expenses; (vi) examining best practices in other states; and (vii) developing cost-effective options for enhancing eligibility determination in the Commonwealth including alternative delivery models.