By Stan Dorn, Urban Institute

Sometimes people fear that streamlining Medicaid and CHIP enrollment and retention may increase error rates. Louisiana has once again shown, in the words of the Gershwin classic, that “It Ain’t Necessarily So.”

On November 21, 2012, the Centers for Medicare and Medicaid Services released the state’s 2011 Payment Error Rate Measurement (PERM) report. Among all states reviewed, 3.3 percent of eligibility decisions were erroneous. The eligibility error rate in Louisiana? A staggering 0.3 percent, just one-tenth the national average.

These error rates are based on analyzing a sample of each state’s Medicaid and CHIP cases. In Louisiana’s sample, not one person was wrongly granted eligibility. The only error involved someone who was wrongly denied coverage at renewal.

No state has done more than Louisiana to streamline enrollment and retention for children and families. The state’s reforms include administrative renewals whenever data matches show continuing eligibility; obtaining information from consumers by phone, rather than by requesting completion of paperwork; granting coverage based on a reasonable certainty of eligibility; permitting electronic signatures; shifting from paper to electronic case records; business process reengineering and focusing on culture change within social service offices; expediting renewal for families living on fixed incomes; and Express Lane Eligibility.

In its last PERM review, Louisiana proved that its approach to eligibility can strengthen rather than weaken program integrity. Louisiana had a Medicaid eligibility error rate of 1.54 percent—far below the national average of 6.74 percent. This latest PERM review shows great progress both nationally and within  Louisiana—promising omens as the country follows Louisiana’s lead in moving towards a streamlined eligibility determination under the Affordable Care Act.