New Medicare Database Expected to Streamline Eligibility

CMS will launch a comprehensive database next month that will allow health care providers to verify Medicare beneficiaries coverage from any location in the country, Federal Computer Week reports. The $6 million project will merge data from several existing databases to serve as a single, authoritative source of information about Medicare enrollees. The database will include information such as addresses, demographic information and eligibility, but not patients' medical records. According to CMS CIO Gary Christoph, the new system will replace a multi-database system that was "aging and creaking." He said that between the legacy system's deficiencies and increasing demand, it could take up to 26 hours to process a single day's eligibility verifications. The new database will also facilitate claims processing without requiring special "data match runs" previously required for routine administrative functions like tracking private insurance responsibilities and cross-checking dual eligibility for Medicare and Medicaid, according to Bruce Vladeck, a former agency director.

The new database will also allow verification of eligibility for seniors who live at different addresses at different times of the year. This change, in particular, is expected to improve eligibility verification for the "millions" of Medicare beneficiaries who winter in warmer parts of the country. Care providers will not have direct access to the database. Instead, they will be required to e-mail Medicare to confirm a patient's coverage. CMS announced the database project Dec. 6 but did not provide details (Hasson, Federal Computer Week, 12/18).