Medicaid Enterprise System Procurement Strategy

On February 5, 2014, the Centers for Medicare & Medicaid Services (CMS) approved the Florida Medicaid Planning Advance Planning Document (PAPD) for the Agency for Health Care Administration (AHCA or Agency) to contract with consultants to provide research and planning, project management office (PMO), and independent verification and validation (IV&V) services to assist with the procurement of a new fiscal agent contract and enhancements to, or development of, the Florida Medicaid Management Information System (FMMIS) and Decision Support System (DSS)/Data Warehouse (DW).

On December 3, 2015, CMS published its Mechanized Claims Processing and Information Retrieval Systems (90/10) Final Rule (CMS 2392-F). The new regulation, which added to and updated current Medicaid Management Information Systems (MMIS) conditions and standards for enhanced federal funding, is available at https://www.gpo.gov/fdsys/pkg/FR-2015-12-04/pdf/2015-30591.pdf. Although a modular design approach is integral to the new rule, specific contracting arrangements were not explicit.

CMS’ new guidance raised significant issues and questions which required Florida to reassess the impact of new requirements on the projects’ schedule, costs, and associated risks. While CMS’ guidance to states is still evolving, the Agency continues to work with federal CMS to assess the most efficient path forward for a new approach to its Medicaid Enterprise System (MES). The resulting Florida MES Procurement Strategy articulates the Agency’s high-level plans to advance the Medicaid Information Technology Architecture (MITA) maturity of the MES. This new strategy is subject to adjustment as further research and planning is completed and additional guidance is released by CMS.

Medicaid Enterprise System Procurement, Updated November 17, 2016 (New Timeline) [584KB]

FL-17-003: CMS approval letter for Florida's IAPD-U for SEAS vendor, 12/21/2016 [74KB]

September 2016, the Agency procured the services of a Strategic Enterprise Advisory Services (SEAS) vendor who is required to provide strategic advice, technical guidance and programmatic support in the mplementation of the plans articulated in the Medicaid Enterprise Systems (MES) Procurement Strategy. The Agency additionally procured the services of an Independent Validation and Verification vendor to provide federally required oversight of the complex system procurement project.

February 2017, CMS approved a Planning Advance Planning Document (PAPD) that requested funding to implement Phase II of the Agency's Medicaid Procurement Strategy. These activities include the procurement of the Systems Integrator/Enterprise Service Bus and the Enterprise Data Warehouse.

Archive: Additional Project Information and Previous CMS Guidance