HHS Panel Backs Plan to Build Federal Database of Eligibility Rules for State Health Programs

A Health and Human Services Department panel has shown support for a plan to create a federal database of business rules that states can use in determining eligibility of consumers for Medicaid and other federal health insurance programs, according to a Government Health IT report.

The database of eligibility rules will allow states to come to one place to compare their enrollment processes with other states and look for ways to re-use or merge health program enrollment systems.

Among some of the business rules for Medicaid eligibility is a rule that requires insurance seeker's income level to be under a certain threshold of the federal poverty line. The majority of the business rules are not currently known or accessible, according to the report. The Health IT Policy Committee has also recommended that states verify personal information of consumers applying for health programs, such as personal income, citizenship and legal status.

Additionally, the Internal Revenue Service, Social Security Administration and Homeland Security departments are creating web services states can use in determining eligibility for health and human service programs. The federal agencies have set core data elements, such as name, address and income, to reduce repetition in documentation and make it easier for states to exchange information.

Read the Government Health IT report on the federal database.

Read other coverage on healthcare information technology:

- How Hospital Can Benefit From EHR Implementation: Q&A With Alan Portela, President of CliniComp

- Emerging Technologies for Clinical Documentation Improvement


- American Board of Medical Specialties to Include Meaningful Use in Certification Program

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