Upgrading Medicaid Technology

In June, Tim Hill Acting Director for CMS https://www.cms.gov sent a letter to State Medicaid Directors on the need to leverage Medicaid technology to address the opioid crisis. The letter emphasizes the importance of using data driven approaches by using prescription monitoring tools and increasing the use of telemedicine especially in rural areas.

The letter emphasizes the need to improve Prescription Drug Monitoring Programs (PDMP) by integrating PDMP data into EHRs to limit provider burden and improve interstate HIEs. This integration would not make it necessary for providers to log in to a separate system, manage a separate log in, and wouldn’t disrupt the workflow to query the PDMP.

Another step forward might enable states to add systems to support the Electronic Prescribing of Controlled Substances (EPCS). These systems could be integrated into other pharmacy systems of HIE architecture and complement broader state initiatives related to prescribing

The letter addresses how Medicaid should handle advance analytics and public health data as relates to the nationwide public health opioid crisis. States are encouraged to consider linking screening data from risk assessment tools such as the Opioid Risk Tool, a screening tool to be used by adult patients in primary care to assist with opioid abuse.

States are encouraged to use telemedicine and telepsychiatry to facilitate more coordinated care to help individuals with Substance Use Disorder (SUD). The letter reminds the states that they need not necessarily submit a state plan amendment to begin delivering covered Medicaid services via telehealth modalities.

State plan amendments are only required if a state decides to reimburse for telemedicine services differently than they pay for face-to-face services, visits, and consultations. States should also consider telehealth optimized Medication Assisted Treatment be given access consideration.

The letter suggests using virtual treatment centers or remote counseling options to address provider shortages particularly in rural areas. States might also leverage business processes so that electronic care plans could be shared and used to coordinate care between providers while also connecting SUD treatment providers.

The letter also mentions that enhanced federal funding under the HITECH Act might be provided to support the design, development, and implementation of interoperable systems and HIEs to make it possible to exchange of electronic care plans.

Go to https://www.medicaid.gov/federal-policy-guidance/downloads/smd18006.pdf for the CMS letter dated June 11, 2018 sent to State Medicaid Directors.


Share Button