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Status Not under consideration
Categories Social Program Management Platform
Created by Timothy Cozine
Created on Sep 21, 2021

RELATED IDEAS

Integrated MAGI/Non-MAGI decisions

We would like to have the ability to integrate MAGI and Non-MAGI decisions in a single hierarchy to ensure proper determinations based on clients circumstances regardless of whether they are on HCR or CGIS case.

Customer Name South Carolina
  • Attach files
  • CLAIRE MCGAFFEY
    Reply
    |     Aug 6, 2022

    Hi Timothy,

    We have reviewed your enhancement suggestion. Based on the information provided, our understanding of your request is as follows:

    • You are requesting a single combined MAGI and Non-MAGI hierarchy for rules-based decisions to ensure proper determinations based on client circumstances regardless of whether they are on an Insurance Affordability or Income Support case.

    The Cúram SPM platform does allow for a combined MAGI/Non-MAGI hierarchy for rules-based decisions to be implemented by customers. Decision outcomes of Cúram SPM cases can be easily made to be dependent on the results from other cases; for example, a potential award for a Non-MAGI benefit can be made dependent on the failure to award MAGI benefits. In effect one of the inputs to the award of a non-MAGI case is the negative outcome of a MAGI case decision. In this way the entire hierarchy can be represented through configuration-based changes to Cúram SPM Income Support components.

    In addition, as of v8, enhanced support is provided for cascading eligibility between non-MAGI Medicaid and MAGI Medicaid programs. Eligibility data is shared between non-MAGI Medicaid and MAGI Medicaid programs to support scenarios where MAGI Medicaid eligibility can be denied where an individual is determined eligible for a non-MAGI Medicaid program (Traditional Medical Assistance). While the cascading eligibility provided in product takes a client's eligibility for non-MAGI into account when determining eligibility for MAGI, the Cúram SPM platform can also be customized to support the use case where a client's eligibility for MAGI is taken into account when determining eligibility for non-MAGI. Please refer to the following What's New Guide link for further information: https://www.ibm.com/docs/en/spm/8.0.0?topic=wn-whats-new-in-cram-social-program-management-800#spm_800_whatsnew__casegrpelig

    Although we will not be addressing this item in the near term, we do have plans to investigate how a consolidated Person Overview card might be able to help in this area. We are closing this request and do not plan to take any further action.

    Regards,

    Sheryl Brenton, SPM Product Management Team

  • Guest
    Reply
    |     Feb 28, 2022

    Hi Timothy,

    We would like to inform you that we are still in the process of reviewing your request. We apologise for the delay however there are some complex issues we need to evaluate to ensure we conduct a thorough assessment.

    Upon completion of our review, we will get back to you with a formal response or to request additional information.

    Thank you again for working with us on building our product roadmap. We appreciate the time you have taken to share your ideas with us.

    Regards,
    Sheryl Brenton, SPM Product Management team

    Note: We have improved your RFE experience and transitioned to an Ideas Portal provided by our trusted business partner Aha!
    Additional details can be found here.

  • Guest
    Reply
    |     Sep 22, 2021

    Hi Timothy,

    Thank you for taking the time to share your ideas with us. We are committed to involving our users in building our product roadmap and appreciate your suggestions.

    We will review the information you have provided and get back to you within 30 days. If additional details are required in order to complete our evaluation, we will send you a request for more information.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.
    Note: we are currently in the process of improving your RFE experience and will soon transition to an Ideas Portal provided by our trusted business partner Aha!
    Further communications with additional details will be shared shortly.