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Florida Health Care Connections Procurement Strategy

The purpose of the Florida Health Care Connections Procurement Strategy is to articulate the high-level plans the Florida Agency for Health Care Administration (Agency) continues to develop in order to advance the Medicaid Information Technology Architecture (MITA) maturity of the Medicaid enterprise. This strategy will be used to communicate Florida’s approach with the Centers for Medicare and Medicaid Services (CMS), and other stakeholders, including the State of Florida Legislature, healthcare information technology (IT) vendors, and other entities that interact with the Agency and are part of the Medicaid enterprise.  This strategy is subject to revision as future research and planning is completed and additional guidance is released by CMS.

In July 2018, the Agency rebranded the Florida Medicaid Enterprise System (MES) to Florida Health Care Connections (FX). The decision was made to reflect this project as a broader project leveraging the Medicaid infrastructure to improve overall Agency functionality and to build better connections to other data sources and programs. Moving forward, the Agency intends to use the term FX when referencing the Florida Medicaid Enterprise Systems. The strategy document linked below is being updated and a new version will be posted in April 2019.

The current Florida Medicaid enterprise includes services, business processes, data management and processes, technical processes within the Agency, and those interconnections with systems that reside outside the Agency necessary for administration of the Florida Medicaid program.  The Florida Medicaid enterprise includes both the Florida Medicaid Management Information System (FMMIS), a Decision Support System (DSS) and other systems that function to support Florida Medicaid and the Agency.  Such Agency systems include, but are not limited to, the enrollment broker system, third party liability, pharmacy benefits management, fraud and abuse case tracking, prior authorization, home health electronic visit verification, provider data management system, and Health Quality Assurance licensure systems.  The Florida Medicaid enterprise also includes systems that reside outside the Agency such as systems hosted by the Department of Children and Families, Department of Health, including Vital Statistics, Department of Elder Affairs, Agency for Persons with Disabilities, Florida Healthy Kids, Department of Financial Services, Florida Department of Law Enforcement, and Department of Juvenile Justice.  DXC Technology (formerly Hewlett Packard Enterprise) is the current Florida Medicaid fiscal agent for operation of the FMMIS and the DSS.

In the future, components of the Florida FX will integrate seamlessly through an integration platform solution.  The foundational steps for advancing the FX level of MITA maturity were to develop integration standards for connecting services and infrastructures.  With these activities completed, the Agency is prepared to procure the services of a System Integrator and development of an Integration Platform to establish the infrastructure needed to integrate existing systems and introduce new modules into the FX.  An Enterprise Data Warehouse (EDW) is the companion piece of the infrastructure to advance the Agency’s efforts to transform the FX from current state to future state of the FX Program.

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 implementation 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