How to Meet the New Rhode Island State Medicaid Reporting Requirements

By John Giknis  |  October 17, 2012

Under a recently passed law, all insurers that write workers' compensation or liability policies in Rhode Island now must participate in a data match program called the Medicaid Assistance Intercept Service (MAIS). The new Rhode Island law requires insurers to report liability and workers' compensation claims to MAIS. The program will let the state intercept payments for reimbursement to Rhode Island Medicaid.

The Rhode Island Executive Office of Health and Human Services (RI EOHHS); ISO, a Verisk Analytics company; and insurance trade organizations American Insurance Association (AIA) and Property Casualty Insurers Association of America (PCI) collaborated to create the ISO ClaimSearch Medicaid Reporting Service. Insurers can comply with the law by reporting through ISO ClaimSearch.

Developed with processes similar to the Child Support Lien Network (CSLN)program, also established by RI EOHHS in 1999, MAIS requires insurers to report all injury claims involving Medicaid recipients through an industry database. The purpose is to determine whether the claims by Medicaid recipients filed under property/casualty insurance policies have also been submitted to Medicaid for payment.

The ISO ClaimSearch Medicaid Reporting Service will handle MAIS reporting for you. Simply report your claims to ISO ClaimSearch as you always do, using Universal Format.

The ISO ClaimSearch Medicaid Reporting Service is available to insurers and self-insureds. There is no additional fee to ISO ClaimSearch participants.

ISO ClaimSearch Medicaid Reporting Service should be operational by the end of October.

John Giknis

John Giknis, CPCU, SCLA, RPA, AIC, retired from Verisk in 2012. As ISO’s assistant vice president for ISO ClaimSearch Operations, he was responsible for the business operations of ISO ClaimSearch, the property/casualty insurance industry’s all-claim database.