Promising Start for Rhode Island Medicaid Intercept System

The Rhode Island Executive Office of Health and Human Services (EOHHS) launched the Medical Assistance Intercept System (MAIS) in late 2012. MAIS provides a proactive tool for states to add to their repertoire for Medicaid recoveries. By identifying and establishing liens for medical bills paid on behalf of Medicaid recipients and matching insurance claims with the recipient, MAIS streamlines the discovery and potential recoupment of medical costs that should be covered by other responsible third parties. This results in strengthened Medicaid programs for communities while meeting state budgetary needs.

 

In collaboration with the insurance industry and attorney offices, MAIS matches personal injury and workers' compensation claims against the Rhode Island Medicaid database. MAIS has processed over 26,000 matches to date and, after performing quality assurance activities, has placed liens on over 440 cases. These liens total over $5.7 million, which is quite significant for a state with 250,000 Medicaid recipients. Some individual liens are substantial, with the largest lien amount valued at over $400,000.

 

Rhode Island and the MAIS program have created an opportunity for states to take advantage of technology by introducing innovative solutions for the Medicaid industry. After fifteen months of operation, MAIS has proven its potential for significant contributions to state Medicaid programs. As MAIS moves forward, Rhode Island is looking to expand the program nationwide to help more states advance their Medicaid efforts.