Michigan awards contract to Medical School to ensure residents receive appropriate federal benefits

By Tom Lyons

UMass Medical School Communications

October 23, 2013

The State of Michigan has awarded UMass Medical School’s Center for Health Care Financing (CHCF) a contract to assist with cost control of Michigan’s Medicaid program by helping the state maximize access to federal Medicare benefits for eligible residents.

As part of its three-year, $3 million agreement with the Michigan Department of Community Health, the Center’s work will include:

• identifying Medicaid beneficiaries eligible for Medicare;

• enhancing outreach efforts to enroll Medicaid members in Medicare;

• reviewing individual entitlement and financial records available from the federal government to identify missed benefit determinations; and

• ensuring that millions of dollars paid by Michigan in Medicare Part A and Part B premiums on behalf of low-income individuals through the Medicare Savings Programs are accurate.

The Michigan Department of Community Health selected CHCF from several competitive bidders because it is part of UMass Medical School’s Commonwealth Medicine division, which focuses on improving the financing of public health care programs. CHCF’s unique expertise in the areas of third-party liability, program integrity and federal benefit eligibility determination helps states ensure that Medicaid is the appropriate payer of health services.

In 2009, research conducted by the Center identified that the Social Security Administration was incorrectly denying thousands of people federal benefits to which they were entitled. This work resulted in more than $250 million in credits to states throughout the country, including nearly $9 million in Medicare premium credits returned to Michigan.

The Affordable Care Act calls for Medicaid to serve as the cornerstone for expanding access to health insurance for millions of uninsured Americans. As states prepare for the full implementation of health care reform in 2014, efforts to manage state health care costs have taken on even greater importance.