AVS Projects Robust Return on Investment Saves a State Millions

Solara Cochran

In August 2013, AutoGov began processing Asset Verification Service (AVS) requests for one of our very innovative and aggressive state government clients. After a successful implementation, the entire team was eager to hit the ground running. We were excited and astonished by the swift return on investment: within the first two hours of operation, the uncovered assets found by our solution paid for the entire program in cost savings.

To gain a greater insight into the meaning of this discovery, we must first understand the costs associated with leaving these assets unfound. Using the net present value of $76,000 as the annual cost of a normal long term care (LTC) Medicaid case, use of the AutoGov AVS solution found a great deal more than previous manual verification programs. In fact, the AVS requests produced over one million dollars in previously unknown depository assets, and the solution took, on average, less than 6 days to uncover well over one hundred submitted cases that exceeded the allowable state threshold for Medicaid.

Congress passed Section 1940 of the Social Security Act. This amendment requires states to implement an electronic Asset Verification System (AVS) for the aged, blind and disabled Medicaid population. AutoGov is on the forefront of innovation for integrated eligibility and program integrity, and our AVS project is one of only two fully implemented solutions in the country.

Until now, Medicaid applicants were only required to volunteer their banking information. As an individual, they could simply choose not to disclose a checking, savings, or certificate of deposit account. Medicaid case workers had no way to verify that applicants were fully disclosing all assets. It's a new day, and that is no longer true. With the help of AutoGov and our data partners, Medicaid caseworkers can be sure they are approving the right individuals.

AutoGov continues to uncover waste, fraud, and abuse for state and federal entitlement programs. For a quick and easy AVS implementation with very little upfront cost, contact Solara Cochran at (512) 439-2900 or email solara.cochran@autogov.com.

States Required to Implement Medicaid Asset Verification System

Gregg Phillips

Federal law compels states to work with banks to check bank accounts for assets when applying for Medicaid long term care. 

The law is clear and unambiguous - states shall implement a system for verifying the existence and balances of checking and savings accounts owned by individuals applying to receive Medicaid benefits for long term care. 

The law, Section 1940 of the Social Security Act (http://www.ssa.gov/OP_Home/ssact/title19/1940.htm) compels the US Department of Health and Human Services to ensure all states have implemented a Medicaid Asset Verification System by September of 2013. The penalty for not installing an AVS solution could be the loss of all Medicaid funding. 

So far, states have been slow to implement the required AVS solution. Florida was first to install AVS with Maryland right on their heels. 

Pilots indicate there could be as high as 17% of Medicaid cases with undisclosed banking assets.

AutoGov is at the forefront of delivering an AVS solution in Maryland that is integrated with an existing eligibility support solution driven by big data analytics and verification solutions from the industry's most effective data providers. 

Squeezing the Juice out of Florida Long Term Care Providers

Randy Floyd

Florida Gov. Rick Scott is one of many state governors requiring state agencies to hammer out ways to achieve significant cost savings over the next year. 

The State of Florida is looking for ways to cut almost half a billion dollars from its Medicaid budget with the nursing home industry expected to shoulder an astonishing $274 million in reductions.  Of course, finding these cutbacks is an enormous challenge.  Where will they come from?

A likely scenario is for the state to increase the scrutiny applied to Medicaid applications.  Several states have already begun to implement advanced data analytics software designed specifically to tighten the process of examining submissions for Medicaid reimbursement to long term care providers. 

At the federal level, the squeeze is about to become even tighter.

Under Section 1940 of the Social Security Act, each state is required to have an Asset Verification System (AVS) in place by the end of 2013 to verify the assets of Medicaid applicants who are aged, blind, or disabled.  States who fail to verify assets will have their federal financial participation (FFP) withheld. 

And what about long term care providers who currently don’t have the same access to advanced analytic tools and AVS systems?  The implication is clear.

Start preparing now before it is too late.

AutoGov Socially

Featured News

AutoGov Releases Updated Risk Management Software for Medicaid and Healthcare Reform

Leveraging analytics driven by more than 30 million cases, CaseVue allows healthcare providers, states and insurance companies with a comprehensive solution to managing risk in eligibility, enrollment and insurance exchanges. CaseVue combines advanced analytics with world-class data to ensure fast, accurate eligibility, enrollment and exchange d.. Continue Reading Continue Reading

AutoGov Unveils New Algorithm for Healthcare Exchanges

Buoyed by more than a decade of success building eligibility tools for Medicaid public and private sector clients, AutoGov’s newest scoring engine creates a bridge between healthcare exchanges and Medicaid. CaseVue Exchange This new scoring algorithm will ensure the handoffs between Medicaid and the state.. Continue Reading Continue Reading

AutoGov Launches New Medicaid Eligibility Tool for Public Use

Buoyed by more than a decade of success building eligibility tools for government and the private sector, AutoGov’s newest version of CaseVue improves access to Medicaid and other services. Austin, TX (PRWEB) September 17, 2010 AutoGov (http://www.autogov.com/) CEO, Rose Hayden, is announcing a new release of her company’s.. Continue Reading Continue Reading

Get in touch