Example HIE Coordination

States must make an effort to coordinate their NWD/SEP system with the Health Insurance Exchange IT system. States should answer the following questions to meet this deliverables:

  • Is the state using the Federally-Facilitated Marketplace or a State-Based Exchange?
  • How does the state route individuals from the Exchange portal to the Medicaid portal?
  • How does the state identify individuals who are ineligible for Medicaid under the rules of Modified Adjustment Gross Income (MAGI), but eligible for Medicaid-funded LTSS under special income rules?