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    Document Summary
    - Report Published -

    House Document No. 10

    Document Title
    Virginia Medicaid Biometric Pilot Implementation Report

    Department of Medical Assistance Services

    Enabling Authority
    Chapter 870 Enactment Clause 1. 4. (Regular Session, 2010)

    Executive Summary
    Biometrics is the science of identifying people based on certain unique physical and/or behavioral characteristics. Examples of biometric identification modalities include face, fingerprint, hand, retina, iris, and walking patterns. The use of biometrics for identification is not a new concept. In fact, unique physical traits have been used to identify individuals for thousands of years. Currently, biometrics are used to identify people in many diverse settings including amusement parks, airports, public schools, hospitals, and federal government facilities. Within health care, biometrics are increasingly being used for identification due to concerns about patient safety, identity theft, and insurance fraud. The use of biometrics in health care will likely increase in the coming years as the industry shifts toward electronic medical records and other health information technologies as required under both the American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act of 2010.

    Recognizing the importance of biometrics, the 2010 General Assembly passed House Bill (HB) 1378 directing the Department of Medical Assistance Services (DMAS) to develop a biometric pilot to enhance efficiency and quality of care, while reducing waste, fraud, and abuse in the Virginia Medicaid Program. HB 1378 specifically states that the pilot is to be implemented as a mandatory program for all recipients residing in three localities and that the program is to be funded entirely using federal funds. To date, the federal government has not allocated any funding for the pilot. HB 1378 also directs DMAS to submit a report to the General Assembly outlining its plan for implementing the biometric pilot. This report fulfills that requirement and contains information on biometrics, the use of biometrics in health and human services settings, and the process that DMAS will follow to implement the biometric pilot through a competitive request for proposal process, should full federal funding become available.

    Two caveats exist to HB 1378 that would affect implementation of the biometric pilot. The first caveat concerns the mandatory participation requirement. According to the Centers for Medicare and Medicaid Services, implementing the pilot as a mandatory program would represent a maintenance of effort violation under both national economic stimulus and health care reform legislation, which could cause Virginia to lose all federal funding for its Medicaid program. To prevent this from occurring, the pilot is designed as a voluntary program. The second caveat involves a cost-free health insurance eligibility and benefits initiative developed by the Virginia Health Exchange Network (VHEN). This initiative gives providers free card swipe machines that can be used to verify patients’ health insurance eligibility status and to calculate their copayment charges for medical services. Implementing the biometric pilot would be hindered if providers decline to participate because they are already participating in VHEN’s free eligibility and benefits initiative.