commercial-off-the-shelf software (COTS)

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A Discussion of Medicaid’s $5 Billion/Year IT Infrastructure Transformation

CMS provides funding to the tune of 5 billion dollars per year to support the Medicaid information technology platforms run by the states. In December 2015, CMS issued a final rule, Mechanized Claims Processing and Information Retrieval Systems (90%  Federal/10% State), to assist states to update Medicaid Management Information Systems (MMIS) in over 20 states. These changes will allow states to improve customer service and support the dynamic nature of Medicaid eligibility, enrollment, and delivery systems. Also within this rule was language directing the Medicaid Enterprise towards an open, modular architecture.

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Sending Medicaid to the Cloud

David Raths | government technology | January 12, 2016

Led by Wyoming, states are ready to pioneer MMIS as a service.

The Wyoming state government already has considerable experience with cloud-based services. It uses Google Apps for Government, NEOGOV for human resources and is looking at for customer relationship management. But as its Department of Health prepares to issue an RFP to replace its Medicaid Management Information System (MMIS), all eyes in the Medicaid IT sector are on Wyoming because it will be the first time a state has tried to move away from an expensive custom-developed system to an MMIS-as-a-service approach.

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