In looking again at the “cats and dogs regulations” released in July, I see that CMS has removed any ambiguity about providing Medicaid and CHIP notices electronically. The health care law directs states to provide consumers with the option to receive notices in a secure, electronic format in lieu of written notices by regular mail. The benefits of electronic notices to both consumers and states are obvious – timely delivery and low cost.

Previous notice regulations required states to mail paper-based, written notices, and served as a barrier to states trying to advance the use of electronic notices. Utah took the lead in demonstrating the effectiveness of electronic notices more than two years ago. (By the way, this link provides a demo of how Utah’s customer account functions work, which is pretty slick and worth a look.)

The new regulations on offering individuals a choice to receive notices and information in electronic format or by regular mail extends the deadline for compliance to January 1, 2015. Despite the delay, the regulation (42 CFR 435.918; 42 CFR 457.110) provides clear direction to states:

1. The individual’s election to receive electronic notices must be confirmed in writing by regular mail, and include information on how to change their election.
2. Notices must be posted in the individual’s account within one business day of the notice generation.
3. The state must send an email or other electronic communication such as a text message alerting the individual that a notice has been posted to his or her account. The alert may not include any confidential information.
4. If the state receives a message that the electronic notice was undeliverable, it must send the notice with an updated notice date by regular mail within three business days.
5. At the individual’s request, the state must provide through regular mail any notice posted to an individual’s account.

The regulation stops short of requiring all communications to be available electronically, but it specifically applies to notices regarding eligibility and fair hearing rights. The preamble to the regulations also noted that covered benefits must be available electronically and that annual renewal forms must be offered in an electronic format. CMS stated that they do not think “it is appropriate or operationally feasible” to extend the requirement to other types of communications such as premium payment information. However, states have flexibility to do so.

E-communications are almost instantaneous so there should be fewer delays in transit, which can be critical when notices are time sensitive, such as requests for information, renewals or premium payment reminders. With gmail and hotmail, people have e-mail addresses that don’t change when they move, a long-standing problem in Medicaid and CHIP.  And the bonus is that electronic communications can save lots of money. It’s a win-win for consumers and states.

[For more on this topic, view the Tech Tuesday blog series by Tricia Brooks or download the CCF-Consumers Union IT Toolkit.]