pre-certification

See the following -

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.

Read More »