This information was taken from the Request for Information (RFI) document and may be updated upon the release of a formal solicitation.
This electronic Request for Information (“eRFI”) is being issued to solicit information from interested suppliers with respect to Integration Platform Maintenance and Operations for the Department of Community Health (hereinafter, “the State Entity”) as further described in this eRFI. The State Entity will use the information generated by this eRFI in conjunction with other information available to the State Entity to determine the solution that is in the best interests of the State Entity to fulfill this need.
In 2016, the Centers for Medicare & Medicaid Services (CMS) issued regulations representing a fundamental change in the way states procure, implement, and certify a Medicaid Management Information System (MMIS). The new modular approach championed by CMS involves packaging a business process or group of processes into a distinct “module” with open Application Programming Interfaces enabling interoperability with other modules. In response to these changes in federal Medicaid information technology regulations and guidance, the Georgia Department of Community Health (DCH, Department) has undertaken the Medicaid Enterprise System Transformation (MEST) Program. MEST involves the deconstruction of Georgia’s legacy MMIS into multiple component modules. These include the following:
- Provider Enrollment
- Claims Processing and Financial Management
- Third Party Liability
- Electronic Visit Verification
- Pharmacy Benefit Management
These modules will integrate onto a DCH-owned, AWS Cloud-based Integration Platform (DCH IP). The DCH IP was built and is maintained by the Georgia Tech Research Institute (GTRI). GTRI provides system integration services for the MEST. In addition to the program modules, the DCH IP will integrate shared services (such as tools for change management and incident response, content management, data services, and security compliance). A number of Business Systems and trade partner systems will also interface with or integrate with the DCH IP including systems providing member data, reference data, prior authorization, healthcare facility licensure and professional licensure status, and Care Management Organization data. GTRI has provided all system integration services for the MEST project.
The MEST, once developed, will run in parallel to the legacy MMIS until cross-module testing has completed and the new modular MMIS will be launched at one time while the legacy MMIS is decommissioned. Go Live is currently targeted to occur around Spring of 2025. DCH is planning to procure the services of a Maintenance and Operations (M&O) Contractor to support many of the day-to-day operations of the DCH IP and System integrator responsibilities in production. The M&O Contractor would be expected to on-board prior to Go-Live and ramp up services through Go-Live, CMS Certification, and beyond into production.
The Department of Community Health (DCH) is interested in learning what prospective Integration Platform Maintenance & Operations vendors will need from DCH in order to respond to a Request For Proposal (RFP). Identifying vendor needs now will allow DCH to gather materials that will facilitate the RFP process and discussions.
