Using Integration to Advance Modularity and Drive Business Results

We’ve all heard the expression “don’t reinvent the wheel” yet how many States use an independent Systems Integrator (SI) for MMIS today? What’s new in MMIS is not new in other industries yet many States have published plans or active procurements to use an independent SI within one year? How many varieties of scope of work are there among these States? In this presentation, delivered at the MES Conference in Baltimore, MD, you’ll learn how to Leverage Best Practices to create an SI for MMIS.

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Considerations for Sourcing the MMIS Systems Integration Role

At the 2016 MES Conference in St. Louis, MO, Blue Tack Consulting presented a framework for sourcing the newly created Systems Integration role for Medicaid replacement and enhancement projects. Lorrie Scardino, Blue Tack’s Managing Director, drew on best practices and lessons learned from other industry sectors to create an approach for states to define the Systems Integration role to meet the unique needs of each state while allowing the market to coalesce around a common set of requirements.

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A Bold Solution for a Broken System: A Handbook for MMIS Reform

Lorrie Scardino, Blue Tack’s Managing Director, was selected by the Center for Digital Government and the Governing Institute to participate in the MMIS as a Service project. The work group consists of volunteers from ten state Medicaid Agencies and three private sector companies and was charged with studying alternatives to traditional MMIS replacements. In the first part of 2015, the group studied the benefits of a services approach and the obstacles to procuring, deploying and certifying MMIS as a Service under current and proposed federal funding rules. The group’s findings were presented at the Medicaid Enterprise Systems Conference in August 2015 and provided to Centers for Medicare & Medicaid Services (CMS) as it worked on the final rules published at the end of 2015.

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Managing the Risk of Innovation

States want innovation in the Health and Human Service Enterprise and many take steps to introduce innovative concepts and models. Because innovation challenges and changes the status quo, it is risky and governments, by design, are not risk takers. Therefore, the road to innovation is long and arduous. The health care industry has also been grappling with the innovation dilemma for decades. The good news is, the logjam is starting to break and case studies and best practices are emerging. In this session, we looked at the pace of innovation in the health care sector, heard from the State of Mississippi about its revolutionary tele-health initiative and discussed best practices for mitigating and managing innovation risk in the public sector.

This presentation was a three part collaboration by Lorrie Scardino, David Gallegos, and Dorthy Young.

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MITA-Size Your RFPs

Originally presented at the 2014 MES Conference in Denver, CO, Blue Tack’s founder, Lorrie Scardino, discussed the need to align RFP requirements with the MITA framework and provided practical ways to MITA-Size RFPs.

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Using the MITA SS-A to Align Procurements with Your Future State

Blue Tack’s Managing Director, Lorrie Scardino, moderated a panel at the 2014 MES Conference that presented best practices and lessons learned for using the MITA SS-A to drive the enterprise’s procurement strategy. The states of Minnesota and Vermont shared their experiences and provided insights to help other states leverage the SS-A to achieve the desired future state.

Download PDF View the Session Abstract at at www.mesconference.org (links to the presentations are available in the abstract)

New MMIS 90/10 Funding

Effective as of January 1, 2016

This final rule extends enhanced funding for Medicaid eligibility systems as part of a state’s mechanized claims processing system and updates conditions and standards for such systems, including adding to and updating current MMIS standards. The new rules allow 90% federal match for modern computing and technology delivery models, such as open source, software-as-a-service and commercial, one-to-many applications, paving the way for MMIS modules to replace monolithic systems.

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Medicaid Managed Care Rules

On April 25, 2016, the Centers for Medicare & Medicaid Services (CMS) put on display at the Federal Register the Medicaid and CHIP Managed Care Final Rule, which aligns key rules with those of other health insurance coverage programs, modernizes how states purchase managed care for beneficiaries, and strengthens the consumer experience and key consumer protections. This final rule is the first major update to Medicaid and CHIP managed care regulations in more than a decade.

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The Medicaid Enterprise Certification Toolkit

The Medicaid Enterprise Certification Toolkit (“Toolkit”) was developed to assist states as they plan, develop, test and implement their Medicaid Management Information Systems (MMIS). The v2.0 Toolkit has been updated to accommodate modular and agile development, refined certification criteria, a new approach to CMS-State partnership during MMIS development, and to reflect the latest regulations and guidance.

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Private Sector Technology Group’s Comments Regarding Proposed Rule: CMS-2392-P

Medicaid Program: Mechanized Claims Processing and Information Retrieval Systems 90/10 Funding

Blue Tack Consulting participated with 15 other companies to present a unified response to CMS proposed rule changes for 90/10 funding for MMIS and Eligibility and Enrollment technology investments in the Spring of 2015. The comments helped shape the final rules, which were published in December 2015.

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