Sunday, August 7, 2011

CMS Certifies MMIS

The state of Massachusetts has received full federal certification by CMS for its Medicaid Management Information System (MMIS). This ensures that the state will receive maximum federal funding for the claim system’s implementation and ongoing operation. The state’s 24,000 Medicaid providers will use the new system which will have the capacity to process approximately 75 million eligibility verifications and 80 million claims worth $6.5 billion per year

HP Enterprise Services designed the system for the Executive Office of Health and Human Services to bring the claims system into the 21st century, to provide for the timely payment of claims, and to comply with state and federal regulations. HP administers $95 billion in benefits a year and serves as the fiscal agent or principal IT provider for Medicaid in 21 states.

. The MMIS will provide for:

• An enhanced provider web portal featuring online enrollment, real-time claims processing and status updates, member eligibility inquiries, prior authorization approvals, and enhanced security

• A service-oriented architecture that integrates and secures information exchange, including member updates from the agency’s multiple determination systems as well as interactive services for providers and other systems improving efficiency

• Online self-service features that have increased enrollments and significantly reduced paper transactions, improving client experience as well as lowering waste consumption

• Features that consolidate health data and operational processes such as member enrollment and card issuance, eliminating the need to access multiple systems

“As states prepare for the entry of millions of new Medicaid patients into the system over the next few years, they are looking for flexible, yet powerful information systems to ease administrative and provider workloads,” said Susan Arthur, Vice President, U.S. Healthcare, HP Enterprise Services. “Using our industry-leading certification experience while collaborating closely with the state of Massachusetts and a provider advisory group, we were able to successfully deliver a user-friendly, federally certified MMIS.”