Milestone: Enable electronic data exchange among programs to obtain information needed for eligibility determinations
Electronic exchange of data needed for eligibility determinations simplifies the process for both the applicant and the system, eliminating or reducing substantially the documentation burden.
*Full name: Enable electronic data exchange among programs to obtain information needed for eligibility determinations.
*Relevance to the ACA:
The ACA requires states to develop electronic interfaces for exchange of data and third-party data matching to the greatest extent possible to determine eligibility for Medicaid, CHIP, the basic health program and tax subsidies. Provisions relevant to electronic data exchange include:
§1411 – An Exchange must submit information to the Secretary to verify information provided by an applicant, including information on citizenship or immigration status and income.
§1413 – Requires states to develop secure, electronic interfaces for exchange of data for all state health subsidy programs, and requires Medicaid, CHIP, and Exchanges to participate in data sharing. The Secretary may establish agreements for the sharing of data; these agreements must protect privacy and data integrity.
§1414 – Parameters around the disclosure of taxpayer information and social security numbers to the Secretary, the Exchange or a state agency when necessary to determine eligibility for premium tax credits in the Exchange and other state health subsidy programs.less