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GAO-11-594R 1 (2011-05-02)

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T I  M Accountability * Integrity * Reliability
United States Government Accountability Office
Washington, DC 20548


          B-321876


          May 2, 2011

          The Honorable Max Baucus
          Chairman
          The Honorable Orrin G. Hatch
          Ranking Member
          Committee on Finance
          United States Senate

          The Honorable Fred Upton
          Chairman
          The Honorable Henry A. Waxman
          Ranking Member
          Committee on Energy and Commerce
          House of Representatives

          Subject: Department of Health and Human Services, Centers for Medicare &
                  Medicaid Services: Medicaid Program; Federal Funding for Medicaid
                  Eligibility Determination and Enrollment Activities

          Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a
          major rule promulgated by the Department of Health and Human Services, Centers
          for Medicare & Medicaid Services (CMS), entitled Medicaid Program; Federal
          Funding for Medicaid Eligibility Determination and Enrollment Activities (RIN:
          0938-AQ53). We received the rule on April 14, 2011. It was published in the Federal
          Registeras a final rule on April 19, 2011. 76 Fed. Reg. 21,950.

          The final rule revises Medicaid regulations for Mechanized Claims Processing and
          Information Retrieval Systems. The final rule also modifies CMS's regulations so
          that the enhanced federal financial participation is available for design, development,
          and installation or enhancement of eligibility determination systems until
          December 31, 2015. The final rule also imposes certain defined standards and
          conditions in terms of timeliness, accuracy, efficiency, and integrity for mechanized
          claims processing and information retrieval systems in order to receive enhanced
          federal financial participation.

          The final rule has an effective date of April 19, 2011. The Congressional Review Act
          (CRA) requires a 60-day delay in the effective date of a major rule from the date of
          publication in the Federal Register or receipt of the rule by Congress, whichever is


GAO- 11-594R

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