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Appendix B (Part 1)

1. Executive Summary

Senate Bill 1587, passed in 1999 during the 76th Legislative Session, required that alternative strategies for authenticating Medicaid eligibility, including electronic methods, be identified. The Texas Comptroller of Public Accounts, chair of the Interagency Task Force on Electronic Benefits Transfer (EBT), contracted with GovConnect (formerly Renaissance Government Solutions) to produce a ten year strategic plan for electronic services delivery (ESD), to include the analysis of an electronic medical identification (Med ID) system.

The Med ID system is the method through which Medicaid recipients are provided documentation of their Medicaid eligibility. In turn, providers use the Med ID to verify eligible individuals and the services for which the individuals are eligible. The current Med ID is a paper form, and approximately 1.3 million of these forms are mailed each month. 1

Med ID issues, concerns related to fraud, and the need to improve the Med ID process have been examined in the past. A Med ID task force began looking at the issues almost three years ago. In March 1998, the Texas Department of Health (TDH) and the Texas Department of Human Services (TDHS) released a report summarizing the results of a survey of the Health and Human Services Commission (HHSC) and each of the eleven HHSC agencies. 2 The survey assumed that a card-based electronic system would be developed, and asked a number of questions regarding specific policy and design issues inherent in an electronic system. Overall, the survey responses and the report supported an electronic Med ID concept. One significant finding from the survey was that while most agencies were willing to donate staff time, expertise, and even funding for the project, no agency volunteered to assume executive leadership for the initiative. In addition, initial consideration of the electronic Med ID concept did not integrate this system with the Lone Star Card, and little progress has been made.

This analysis and the resulting recommendations focus on the paper form and monthly mail-out process, and build upon the work done by the Med ID Task Force and other agencies. Recommendations in this report include replacement of the current process with an electronic system integrated with the Lone Star Card, currently used to provide Food Stamps and financial benefits under the Temporary Assistance for Needy Families (TANF) program. The recommended design and implementation strategies presented below also address issues of integration and leadership.