The 12-month pilot is being implemented in six counties, encompassing approximately 180,000 Medicaid recipients and 900 Medicaid providers. IBG is evaluating systems from Atos Origin, EDS, eMedicalFiles, and MAXIMUS. The Medicaid Integrity Pilot uses biometrics and smart cards to verify the identity of Medicaid recipients at health care provider locations. As the programs Independent Evaluator, IBGs key areas of responsibility include the following: -- Evaluating the accuracy, security, and usability of finger imaging and smart card components -- Providing end-to-end Independent Verification & Validation (IV&V) of vendor systems -- Evaluating vendor solutions for HIPAA/HL7 compliance -- Measuring pilot acceptance on the part of recipients and providers -- Evaluating systems ability to detect and deter fraud in a health care environment -- Providing recommendations on potential expansion of the pilot to statewide implementation Texas House Bill 2292 mandates that HHSC develop and implement a front-end authentication and Medicaid fraud prevention system pilot program.
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