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6.6H. Title XIX claims processing
Answer
Paragraph 1355.52(e)(2)(iii)(B) requires title IV-E agencies to maintain in CCWIS the available medical record information received from the MMIS, which would include the Medicaid claims history or, for those enrolled in managed care, provider encounter data.
Source/Date
11/7/2016
Legal and Related References
45 CFR 1355.52(e)(2)(iii)(B); 81 FR 35450 at 35465 (issued June 2, 2016); 80 FR 48200 at 48213 - 48214 (issued August 11, 2016)
Answer
No.
Source/Date
11/7/2016
Legal and Related References
45 CFR 1355.52(e)(2)(iii)(B); 81 FR 35450 at 35465 (issued June 2, 2016); 80 FR 48200 at 48213 - 48214 (issued August 11, 2016)
Answer
Yes, to the extent practicable. The bi-directional data exchange is required to provide CCWIS with all relevant data to serve clients and improve outcomes, including information on prior medical services, such as immunization histories, therapies, and prescriptions. Although the title IV-E agency may already have access to some of this information, implementing a bi-direction data exchange also improves efficiency by reducing duplicate data entry and provides the state title XIX program with data collected by the title IV-E agency that it may use in serving foster children.
Source/Date
2/12/2018
Legal and Related References
45 CFR 1355.52(e)(2)(iii)(B); 81 FR 35450 at 35461 and 35464 - 35465 (June 2, 2016); 80 FR 48200 at 48211 - 48214 (issued August 11, 2016)