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This week, the Centers for Medicare & Medicaid Services (CMS) issued the Interoperability and Patient Access final rule. The final rule requires daily state-CMS exchange of data to identify who is enrolled in Medicare, and which party is liable for paying each beneficiary’s Parts A and B premiums. The final rule also requires daily state submission of files that identify whether a beneficiary is dually eligible for Medicaid and Medicare. Currently, states and CMS exchange these data as infrequently as weekly or monthly in 35 states. Both of these provisions require daily exchange by April 1, 2022.

The Center submitted comments to the proposed rule in June 2019 calling for the daily exchange of data. The Center applauds CMS for making this change; less frequent exchanges of data can lead to increased costs for beneficiaries if the state is not able to activate or terminate coverage in a timely manner. Daily submissions, and the ability for states to receive daily response files from CMS, spread state staff workload more evenly across the month, permit errors to be corrected more quickly, and connect new beneficiaries more quickly to benefits.

March 12, 2020 – K. Kertesz

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