The Puerto Rico Medicaid Program undertook the modernization of its Eligibility and Enrollment (E&E) system and processes in order to respond and comply with the requirements of the Centers for Medicare and Medicaid Services (CMS) and the Affordable Care Act of 2010 (ACA). PRMP’s primary objectives included improving its eligibility processing capabilities and implementing a new system in a controlled, deliberate manner to realize these outcomes: 

• Simplifying the Medicaid application process for citizens in Puerto Rico
• Achieving full compliance with federal requirements and CMS guidance
• Improving the accuracy of Medicaid eligibility determination
• Reducing operational cost through electronic verification and real-time processing 

Intervoice’s active project management and subject matter support helped PRMP achieve its goals for the project.