How Alabama Medicaid Leveraged Its HIE to Satisfy CMS Interoperability Rules compliance.

Synopsis: In developing a strategy that aligned with the objectives of our Alabama MES Modernization Program (AMMP), took advantage of the existing Health IT investment, and complied with CMS Rules of Interoperability, Alabama Medicaid saw the opportunity to leverage the State HIE, Alabama One Health Record®. Alabama Medicaid uses the State’s HIE framework and architecture to comply with the present CMS Interoperability requirements under CMS 9115-F, and, in turn, has built the capability for addressing the pending CMS Interoperability Rule CMS 0057-P for Prior Authorizations and Health Plan exchange.

Alabama Medicaid will highlight our approach as an example in addressing the challenge of CMS Interoperability compliance and the opportunity provided to integrate State HIE capabilities into the Medicaid Enterprise Systems (MES) umbrella. We will share the benefits and advantages that we are experiencing that complements the State’s investment in Health IT, while maintaining independence and flexibility to develop future interoperable solutions.