Medicaid will use federal tax data to determine eligibility

Louisiana’s new Medicaid eligibility and enrollment system will now give the health department access to federal income tax data of potential Medicaid enrollees to ensure they are eligible for Medicaid. This capability is in addition to numerous other income and employment data sources that are now available to Medicaid to ensure that all recipients meet the strict financial eligibility standards.

The new system has replaced a 1990’s-era computer system that used manual entry processes to determine eligibility. Where the old system required eligibility workers to manually access separate and individual data sources to verify income and employment, the new system automatically connects to 20 different data sources to verify eligibility.

Beginning next year, the system will automatically connect to the federal tax information system. This data source will be another tool that will assist Medicaid in verification of yearly reported income, tax filing status and household size. Since each of these information sources has a role in eligibility determinations, Medicaid staff have verification from another source of annual financial information.

Dr. Rebekah Gee, secretary of the Louisiana Department of Health, said replacing the aging eligibility system has been a priority for this administration.

“Whether in a response to an audit or to legislators, we have testified numerous times about the limitations of the computer system we inherited. Today, we now have the system and tools to make more accurate Medicaid eligibility decisions,” Gee said.

The new system will check the following data sources for each application: 

In addition to improved income verification, the new Medicaid system is expected to improve documentation, help to ensure that eligibility policies and procedures are followed, and create a single system that captures critical case file information.