The Center for Medicaid and CHIP Services (CMCS) is responsible for overseeing compliance with 42 CFR Part §433 Subpart C and 45 CFR Part §95 Subpart F, including administrative simplification and various federal and state initiatives relevant to modernization of Medicaid healthcare systems. The Data and Systems Group (DSG), within CMCS, provides oversight, funding, technical assistance, and guidance to state Medicaid agencies for state Medicaid enterprise systems (MES). States’ systems enable efficient operations of the Medicaid and CHIP programs by supporting information technology functions related to beneficiary eligibility, enrollment, care management, and other beneficiary-facing tools. These systems also serve provider enrollment and payment, benefits management, data analytics and reporting, health information exchange, fraud and abuse detection, and more.
DSG continues to partner with states to streamline processes to procure, manage, monitor and report on IT investments to maximize the positive impact of federal investments on the Medicaid program. Holding states accountable for improvements to the Medicaid program federal investments is intended to achieve, and simultaneously alleviate, administrative burdens on the states.