Jul 28, 2010

Florida Medicaid Achieves Federal Certification of Fiscal Agent System

Florida Medicaid Achieves Federal Certification of Fiscal Agent System
~Enhanced federal match is retroactive to implementation date~

The Agency for Health Care Administration (Agency) today announced that the Florida Medicaid Management Information System (MMIS) has received full federal certification from the Centers for Medicare and Medicaid Services (CMS). Certification is provided when CMS determines that the state’s system is likely to provide more efficient, economical and effective administration of the state’s Medicaid program. The designation is retroactive to the system’s first day of operation, June 23, 2008, and it allows Florida to receive the maximum federal funding of 75% for the operation of the system. The system was designed and built by the Agency and its fiscal agent contractor, HP.

“The successful certification of the Florida MMIS is an important milestone,” Agency Secretary Thomas W. Arnold said. “This not only allows us to obtain enhanced federal funding, but it confirms that this complex system operates accurately to process nearly 135 million claims per year for the 80,000 providers who work with us to serve Florida’s 2.7 million Medicaid recipients.”

The certification review assures CMS that the system meets the federal requirements and is operating in compliance with current regulations and policy. The review includes the design, development and implementation of the MMIS as well as its operation. Documentation must be presented by the state which demonstrates that the entire claims processing system has been fully operational in order to receive the enhanced federal matching funds.

“This successful implementation and certification of the Florida interChange MMIS emphasizes the commitment to quality healthcare for Floridians by the Agency and HP,” said Barbara Anderson, vice president, State and Local Healthcare, HP Enterprise Services. “The strategic utilization of innovative and proven technology will help Florida and other healthcare leaders meet their long-term goals.”

The certification process was organized and facilitated by key Agency contract management staff led by Angela Ramsey, Certification Project Manager. The Agency provided the CMS onsite review team information on privacy and security, the pharmacy benefit management system and the decision support system. The Agency also gave detailed documentation on the following subsystems:

Reference File
Claims Processing
Managed Care
Third Party Recovery
Management Administrative Reporting
Surveillance Utilization Review

Tiffany Vause, AHCA - Press Secretary