New Fiscal Agent

In May 2006, the Agency for Health Care Administration (AHCA) announced a signed contractual agreement with Electronic Data Systems (EDS) to develop a new Medicaid computer system and serve as the State’s fiscal agent for five years. The effective date of this change was previously March 1, 2008; this date has been moved to July 2008. Scheduled training dates will not change and providers should attend any scheduled training sessions. Please visit the Provider Readiness Web Portal for additional information.

The new Medicaid system, referred to as the Florida Medicaid Management Information System/Decision Support System (FMMIS/DSS), will replace the current system supporting claim’s processing and will include Web Portals for Medicaid providers and recipients. The Web Portal will allow providers to file and reconcile claims, perform eligibility verification, access information on the care given to Medicaid recipients, and automate numerous other administrative functions in the new system. The recipient Web Portal, available in Spanish and English, will allow recipients to access their Medicaid claims history, make provider choices, and report on fraud and abuse.

In addition, the new system will offer flexible technology to support Medicaid reform and timely access of information to facilitate effective measurement of recipient health outcomes, policy decisions, and services for both providers and recipients.

The new system will bring a wide array of new capabilities to recipients, providers, and State users. A few highlights include:

• New Web Portal functionality for recipients allowing online selection of health plans, increased access to information on benefit utilization and service records;
• Providers will also reap new benefits with online, real-time claims processing and resubmission for most claims, online provider enrollment and status, web submission of service authorizations and status, and eligibility inquiry;
• Computer Based Training (CBT) courses for topic specific training, available when it is needed and convenient on the web; and
• A new Pharmacy claims processing system, provided by First Health Services.

The new FMMIS/DSS system and a team of over 400 EDS professionals will provide fiscal agent services to Florida's Medicaid providers and recipients. Under the contract, EDS will implement its core MMIS, customizing the system to meet Florida's specific requirements. Florida Medicaid and EDS look forward to presenting these exciting changes in the Florida Medicaid program.