Medicaid Enterprise Restructuring Project
The Department requests proposals from experienced, responsive, responsible and financially sound organizations and/or teams that have the capability and are prepared to:
1. Provide Fiscal Agent (FA) services for processing and payment of all valid provider
claims in the Title XIX Medicaid and Title XXI State Children’s Health Insurance
Program (SCHIP) in Maryland as well as State-only funded programs (herein referred
to as Medical Care Programs).
2. Design, develop, test and implement a replacement Medicaid Management
Information System (MMIS) with a go-live date no later than September 1, 2013.
3. Maintain and enhance a MMIS that shall meet all current and future needs of DHMH
per State and Federal government functionality and reporting requirements.
4. Include 20,000 hours per year of system modifications and modification support in
their operational price.
5. Operate the MMIS on computer hardware as appropriate to support all Medical Care
Programs functions efficiently with all costs being included in the Financial Proposal.
6. Implement a MMIS that shall facilitate business process reengineering and process
improvement for DHMH.
7. Provide sufficient, knowledgeable and experienced staff to support all functions in the
Offeror’s proposal at the defined Service Levels.
8. Document, in a manner readily apparent for objective oversight monitoring, effective
operation of controls suitably designed for MMIS operations.
9. Identify and propose cost-savings initiatives that could be implemented by DHMH.
Cost-saving initiatives approved by DHMH shall be implemented using a share-insavings
model.
10. Operate and implement Customer Relationship Management (CRM) and Call Center
functionalities.
11. Provide document management, workflow, imaging, scanning, and loading
capabilities for hard-copy data.
12. Provide online services for access to MMIS capabilities.
