Integrated Eligibility
Developing eligibility solutions that cross organizational boundaries and technology infrastructures is challenging. CSG helps you craft effective strategies and coordinated plans for your integrated eligibility initiatives. We also provide comprehensive project assurance services so that your plans are successfully implemented.
CSG'S Expertise in Action
HHS System Modernization in Missouri
The Missouri Department of Social Services (DSS) has launched an initiative to modernize its integrated eligibility system. When fully implemented, the new customer-centric system will process applications in real-time and provide the flexibility and core functionality the State needs to leverage the system across all of its eligibility programs and services.
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DSS selected CSG to provide a full-service Project Management Office to oversee the system modernization. CSG develops in-depth project management plans that document the processes and procedures of each business area to help the State establish a comprehensive vision and assure its objectives are met. We provide critical oversight and management of the solutions vendor and project team, identify and track project risks and issues, develop risk mitigation strategies, and facilitate organizational change, including training on the Agile methodology. CSG also supports the State in maintaining effective communication and project transparency with CMS throughout the engagement, including submission of Advance Planning Document Updates to maintain compliance with CMS and obtain enhanced federal funding.
DSS is committed to improving its healthcare and social services programs to provide more efficient services for Missouri citizens. CSG is here to assure the State meets its goals.
Protecting Health Information for Coloradoans
The Colorado Department of Healthcare Policy and Financing is dedicated to improving healthcare access and outcomes for Coloradoans. In order to protect the privacy of the people it serves, the State engaged CSG to perform an independent security and privacy controls assessment and evaluation of its health insurance marketplace and integrated eligibility system’s shared connection to the Federal Data Services Hub.
MARS-E v2.0 Security Assessments
CSG applied CMS’ Minimum Acceptable Risk Standards for Exchanges 2.0 (MARS-E 2.0) and tested each of the more than 350 security and privacy controls. CSG produced a Security Assessment Report with findings and recommendations, which was incorporated into the State’s Plan of Action and Milestone document. CSG also provided an Annual Security and Privacy Attestation for ACA Systems for submission to CMS.
Colorado is committed to protecting the privacy of its residents. CSG’s privacy and security assessment services assure Colorado is protecting the confidentiality, integrity, and availability of Personally Identifiable Information (PII), Protected Health Information (PHI), and Federal Tax Information (FTI).
The Rhode Island Unified Health Infrastructure Project
Rhode Island’s Unified Health Infrastructure Project (UHIP) is a multi-phased effort, developing an integrated technology platform across healthcare and human services programs. UHIP is a collaboration of five Rhode Island government agencies with a vision for a single technology solution that simplifies enrollment for individuals and families eligible for Medicaid/CHIP, SNAP, TANF, and commercial-based healthcare plans. The project includes implementation of an ACA-compliant health benefits exchange solution.
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Rhode Island selected CSG to provide comprehensive IV&V services for the design, implementation, and operation of the UHIP technology platform. CSG conducts proactive project health and risk assessments encompassing the full system development life cycle. Our assessments identify project risks and opportunities to implement best practices. We develop risk mitigation strategies, alternative approaches, and recommendations for improving project performance. CSG also supports Rhode Island in obtaining Federal Certification by providing training and developing artifacts, including quarterly E&E IV&V Progress Reports, to demonstrate MEET compliance.
CSG is also leading the State’s user acceptance testing to validate compliance with federally mandated requirements, and is providing independent security assessments and system audits.
Rhode Island is pursuing a vision to improve access to healthcare and human services programs. CSG is there to help achieve that goal.
Illinois' Interoperable HHS Enterprise
As the Illinois Department of Healthcare and Family Services (HFS) mobilized to meet ACA requirements, it launched a major initiative to implement a new integrated eligibility system (IES). The IES links to the State’s health insurance marketplace and supports eligibility and enrollment for multiple HHS programs, including SNAP and TANF.
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HFS selected CSG to establish a Project Management Office and provide other essential services including early technical assessment and strategy for the IES, JAD session facilitation, development of the DDI and Independent Verification and Validation RFPs, and additional procurement support.
Our oversight and management of the implementation contractors and project team assures that all aspects of the project–including requirements management, adherence to the schedule and budget, project governance, technical architectures, testing, and organizational changes–are effectively achieved.
Illinois is pursuing a vision of integrated service delivery that improves the lives of its people. CSG is here to help.
Integrated Eligibility Modernization in Massachusetts
The Commonwealth of Massachusetts’ Health Insurance Exchange and Integrated Eligibility System (HIX/IES) is co-managed by the Massachusetts Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority. The HIX/IES provides a one-stop marketplace that makes it easier than ever for individuals and families to enroll in affordable health coverage that meets their needs.
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CSG was selected to provide IV&V oversight, including ongoing risk management, completion of MEELC IV&V Progress Reports and checklists, and validation testing and attestation for federal compliance. We completed an initial risk and impact assessment and provide continuous reporting related to the project portfolio, structure, management, and approach, as well as all procurements related to the system. To assure project success, CSG applies our expertise to advise stakeholders on all aspects of the project including planning, procurement development, program management, vendor integration, and service level agreements. Our team also performs requirements traceability throughout the entire project life cycle and monitors implementation quality.
EOHHS and the Connector are dedicated to providing integrated services that improve the health and well-being of Commonwealth individuals and families. Together, the Commonwealth and CSG are working to ensure the HIX/IES system efficiently serves the residents of the Commonwealth.
Modernizing Vermont’s Medicaid Enterprise
The Vermont Agency of Human Services and the Department of Vermont Health Access selected CSG to provide IV&V services for its modular Medicaid Management Information System and Integrated Eligibility and Enrollment system implementation project.
Enterprise IV&V for MECL and MEELC
As Vermont’s Enterprise IV&V partner, CSG provides assessments, observations, and recommendations to support the ongoing implementation and ensure project adherence to federal standards. Our assessments and recommendations span the entire Enterprise, supporting reuse of common components or services across modules and informing State leadership of portfolio and project-specific risks. The CSG team also validates that systems satisfy requirements and reviews evidence that demonstrates that the modules achieves certification compliance. So far, the Pharmacy and Care Management modules have completed R3 milestone reviews to achieve final certification.
Vermont is committed to improving its health and human services programs by achieving efficiencies through an interoperable enterprise approach. CSG is here to help with this strategic initiative.
Integrated Eligibility Modernization in U.S. Virgin Islands
The U.S. Virgin Islands Department of Human Services (DHS) is replacing its integrated eligibility and enrollment system called the Virgin Islands Benefit Eligibility System (VIBES). DHS selected CSG to provide full life cycle project management services, including procurement support, quality assurance, risk management, schedule and resource management, and federal compliance services to support the implementation of the second phase of VIBES modules and services, including SNAP, TANF, LIHEAP, Child Care Subsidy, and cash assistance programs.
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CSG establishes repeatable structures that standardize project management processes and deploys tools to identify and mitigate risks, maintain scope, and adhere to project timelines. CSG uses its proven PMO by CSG℠ methodology to coordinate and manage cost, schedule, scope accuracy, completeness, timeliness, and consistency of deliverables throughout the engagement, assuring that the project stays on track and meets Territory goals.
DHS is committed to provide an improved level of service for U.S. Virgin Islands citizens. CSG serves as the Territory's trusted advisor.
Integrating Health and Human Services in Iowa
The Iowa Department of Human Services (DHS) provides public assistance benefits to more than 450,000 Iowans. The current eligibility system has been in place since 1984, making upgrades and enhancements costly and time-consuming. Like other states, Iowa must address new ACA mandates, evolving eligibility determination rules, health insurance marketplace, and interfacing with a new MMIS. In order to support these interconnected challenges, DHS is deploying an integrated system using an Agile development approach.
PMO by CSG SM Delivering Organizational Change
The new integrated eligibility system affects the work processes of hundreds of employees. The department recognized the importance of preparing staff for the planned changes, and selected CSG to help them complete a change assessment, develop a customized change management plan, and move forward with the plan’s implementation. More than 300 key staff have been trained in the principles of organizational change and empowered to serve as change sponsors for the new system.
DHS is committed to providing improved access to healthcare and human services programs for Iowans. CSG is here to help achieve this goal.
Maine's Enterprise Eligibility System Modernization
The Maine Department of Health and Human Services completed an implementation of and migration to a new Business Rules Engine to upgrade technology for their enterprise-wide Automated Client Eligibility System (ACES). The objective of this project was to reduce the time and complexity for implementing business rule changes that are required to support eligibility determinations.
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To ensure a seamless system deployment, CSG conducted forward-looking IV&V reviews and risk assessments for the Business Rules Engine implementation and provided quarterly E&E Progress Reports and Milestone Reviews in compliance with the Medicaid Eligibility & Enrollment Toolkit for CMS approval. CSG also conducted risk assessments, security assessments, system application reviews, and code reviews, including a MARS-E v2.0 security assessment after the state’s major version upgrade to a new platform.
Maine is committed to the security of its overall technology infrastructure and the protection of residents’ personal information. CSG’s IV&V and security assessment services reinforced confidentiality, integrity, and privacy for the agency-wide transition.