ODMR 2627-0006 Request for Information: Verification Eligibility

The Ohio Department of Medicaid (ODM) is seeking information regarding potential improvements to Medicaid eligibility determinations and processing. ODM is looking for current and best practices for using systems and data to improve or augment the management, efficiency, frequency, and accuracy of Medicaid eligibility determinations and processing. Respondents should address topics such as identity verification, death verification, employment and wages, lottery winnings, residency verification, household composition, incarceration status, third-party liability verification, and asset verification. They should also describe their organization's proposed approach to a performance-based pricing model and ensure data privacy and security. Some key points to consider include: • How to address verification of various data points relating to Medicaid enrollees and/or applicants • What records, systems, and/or technology are available to perform eligibility verification • How to prioritize identification of non-eligible applicants and enrollees while minimizing errors • How to ensure data privacy and security, including compliance with HIPAA and other applicable laws and regulations