Thanks to OTS, multiple state agencies/entities and numerous vendors, Louisiana now boasts one of the most advanced and progressive Medicaid enrollment systems in the nation. LaMEDS, or the Louisiana Medicaid Eligibility Determination System, replaced the legacy mainframe system, now allowing applicants to key in their information and receive an automated determination of their Medicaid eligibility. LaMEDS was the first system developed on the unified, standards-based Enterprise Architecture platform established by OTS. LaMEDS consists of three portals:
- Self-Service Portal for citizens and business partners to apply for, renew and report changes to Medicaid coverage
- Eligibility Portal for workers to perform Medicaid eligibility and enrollment
- Provider Portal for submission of provider-related forms such as admissions, status changes, newborns and others
LaMEDS is vital to the Louisiana Department of Health to provide Medicaid eligibility status and confirmation to external entities as necessary, allowing enrollees to receive services in a timely manner and ensuring that providers of Medicaid services can bill and receive payment for services performed. Leveraging electronic data sources (e.g., Federal Tax Income Data, Louisiana Workforce Commission, and other State and Federal Interfaces), LaMEDS performs Real-Time eligibility which, when possible, returns an eligibility decision back to the applicant at the time of submission and periodically performs checks for maintaining ongoing eligibility.
The system went live in November 2018, and OTS Project and Portfolio Management staff members continue to add features, including an upcoming robotic process for paper applications.