Alabama Department of Public Health Beats Deadline and Launches Medicaid Eligibility Platform with InRule®

The Alabama Department of Public Health (ADPH) provides care, high quality and professional services for the improvement and protection of the public’s health. This work includes managing disease prevention and the assurance of public health services for resident and transient populations of the state, regardless of social circumstances or the ability to pay. Simply put, ADPH serves the people of Alabama by assuring conditions in which they can be healthy.

The Challenge
Legislation such as the Affordable Care Act required Health and Human Services (HHS) agencies to comply quickly with government-issued mandates. In response to these requirements, ADPH was looking to create a website that would allow individuals to enter information about themselves and their family to determine their ability to qualify for Medicaid. With many different factors shaping a person’s eligibility, ADPH needed to develop and manage thousands of rules, and this process needed to comply with seven Medical Information Technology Architecture (MITA) standards. To make this project even more complex, ADPH had less than a year to meet the October 1, 2013 deadline for ACA.

Solution
The InRule® business rules management system (BRMS) integrated into ADPH’s newly created online Medicaid eligibility portal. The integration of InRule with the eligibility portal allowed ADPH to collect personal and medical information about individuals and their family members. The data entered by the individuals was then validated using business rules, and the BRMS would then call out to federal systems such as Homeland Security and Social Security for further validation. The user would then find out whether they were eligible for Medicaid benefits and if so, which benefits they were eligible to collect.

Results
InRule was instrumental in helping ADPH meet the October 1, 2013 deadline for ACA and MITA compliance. When asked what he thought about the application development and deployment process, a Senior Manager had the following to say, “InRule is in a class of its own. The BRMS is very intuitive, easy to use and performs great. It provides infinite possibilities to author and extend capabilities. The deployment options available are very flexible… I don’t think there is any other BRMS which comes close to InRule, in any areas, and we have tried couple. The best part is the after sales support and the ROAD services. InRule consultants are experts and dedicated, they value customer success and strive for it.”

“InRule is in a class of its own. The BRMS is very intuitive, easy to use, and performs great. It provides infinite possibilities to author and extend capabilities. The deployment options available are very flexible… I don’t think there is any other BRMS which comes close to InRule, in any areas, and we have tried couple. The best part is the after sales support and the ROAD services. InRule consultants are experts and dedicated, they value customer success and strive for it.”

Senior Manager,

Alabama Department of Public Health