RD343 - Replacement of the Medicaid Management Information System – October 1, 2016


Executive Summary:
The Virginia Department of Medical Assistance Services (DMAS) is replacing its Medicaid Management Information System (MMIS) with a Medicaid Enterprise System (MES). DMAS desires to establish mutually beneficial partnerships with healthcare business-driven technology leaders to collaborate with the Department and other partners in this transition to a more modern Medicaid Business and Technical environment. The Department is identifying collaborative, innovative, cooperative, flexible, and customer-oriented service organizations that are willing to work with the Department and each other to achieve common goals.

As technology has evolved and regulations increased since the initial implementation of the MMIS, the system has become defined by several significant constraints, which include: a general lack of developmental agility, increasing operational costs, and the growing consumption of technical resources necessary to update this dated systems platform. Recent developments in the Medicaid industry and a strategic alignment of federal, state, and agency developments with federal Medicaid Information Technology Architecture (MITA) requirements have increased demands on the existing MMIS beyond limits of the current capacity to respond to business needs quickly and cost effectively.

DMAS has collaborated closely with the Centers for Medicare and Medicaid Services (CMS) representatives and a CMS-sponsored state cohort group on MES procurement approaches to create a roadmap for transitioning from a monolithic mainframe system to a modular enterprise solution.