EE22
Integration with Other Programs
CMS-required outcome
The state maintains a coordinated eligibility and enrollment process with all insurance affordability programs by supporting bi-directional data-sharing for application-related data and adjudication status with all relevant insurance affordability programs (FFE, CHIP, SBE if applicable, BHP if applicable).
Default metrics
- Success rate of Inbound Account Transfers from the state to the FFE (The state does not need to provide data for this metric; it will be taken from the CMS Weekly AT Report).
- Success rate of Outbound Account Transfers from the FFE to the state (The state does not need to provide data for this metric; it will be taken from the CMS Weekly AT Report).
- Success rate of Inbound Account Transfers from the state to the SBE, if applicable.
- Success rate of Outbound Account Transfers from the SBE to the state, if applicable.
- Number of applications sent to the state's separate CHIP (only applicable in states with separate CHIP programs)
- Number of applications sent to the state's Basic Health Program (BHP) (only applicable in states with a BHP.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.1200