This Medicaid Enterprise Systems (MES) bi-monthly e-newsletter contains updates on the following:
- HIMSS: Transforming Health Through Information and Technology
- HIT Connect Summit 2018 Highlights
- Health Information Sharing Maturity Model
- Medicaid Information Technology Architecture Governance Board Update
- Medicaid Module Precertification Pilot is Complete!
- MMIS Cohort: Join the Conversation!
- MES FAQs
Upcoming News & Events
Medicaid Enterprise Systems Conference (MESC) | August 13-16 | Portland, OR
HIMSS: Transforming Health Through Information and Technology
The Healthcare Information and Management Systems Society (HIMSS) conference recently took place in Las Vegas from March 5-9. CMS provided insights on efforts to actively use and repurpose open source software, encourage reuse, and collaborate with interagency partners to improve healthcare outcomes.
- Open Source Provider Screening Module (PSM), A State and Federal Priority: The Provider Screening Module project is a Federal and State partnership to pilot Open Source module development, including piloting models for procuring, developing, and maintaining shared modules. The goal is to produce a fully functional, configurable module that vendors and States can freely incorporate into their systems.
- Partnership and the Health Information Sharing Maturity Model: HISMM provides a framework for a State to assess current Health Information Exchange capabilities based on their identified healthcare priorities. The goal of the maturity model is to help States build a roadmap to improve capabilities to support programs that improve patient experience and population health, while reducing per capita cost of care.
HIT Connect Summit 2018 Highlights
The ninth annual HIT Connect Summit was held April 4-6 at the Hilton Hotel in Baltimore, Md. It was a well-attended success, with over 700 participants from the public and private sectors. The event provided a platform for thought leaders to connect, share ideas, and benchmark implementation strategies of State health IT systems. The agenda included keynotes, keynote panels, collaborative networking roundtables (Meet the Innovators and States of Implementation), the Connect Exhibition, and breakouts assigned to five separate tracks.
If you were unable to attend, please register to access the complimentary archive video-stream (with synchronized PowerPoint) of ALL pre-conference workshops, keynotes, and track sessions.
CMS speakers presented at the sessions detailed below.
| Date | Session One | Session Two | Session Three |
|---|---|---|---|
| April 4th | 1:00pm-2:30pm Track 1 (Pre-Event Workshop): Independent Verification and Validation (IV & V) of Medicaid IT Systems Eugene Gabriyelov, Technical Director, CMCS/CMS Ron Backus, MITRE |
3:00pm-4:00pm Track 1: Presentation – CMS’ MITA Governance Board Announces the Next Medicaid IT Architecture (MITA) Sean Mahoney, MITRA Amanda Starr, CSG Martin Rice, Director, Division of State Systems, CMCS/CMS |
4:00pm-5:00pm: MITA Governance Board Meeting |
| April 5th | 10:45am-11:45am Track 1: PLENARY - Integrating the Modular Medicaid Enterprise: Definitions, Expansion & Traction in the Vendor Marketplace Ed Dolly, CIO, West Virginia Department of Health and Human Resources Joshua Slen, Immediate Past Board Chair, Private Sector Technology Group Ryan Howells, Medicaid Technology Alliance, Principal, Leavitt Partners David Whitham, ACIO Health and Eligibility, Massachusetts EOHHS Martin Rice, Director, Division of State Systems, CMCS/CMS |
4:00pm-5:00pm Track 1: Vendor Module Pre-certification Program Updates from the Pilot Eugene Gabriyelov, Technical Director, CMS Clyneice Chaney, MITRE Carl Engel, CEO/Chief Architect, Elyon Enterprise Strategies representing PegaSystems Alison Barnett, Change Healthcare Pharmacy Solutions (CHPSI), formerly Good Health Systems, CMCS Certification Lead Elizabeth Reed, Program Manager, CSRA State and Local Dave Rice, MRx IT Solutions Owner, Magellan Medicaid Administration David Tamayo, Managing Principal & Regulated Programs and Solutions, MedImpact Healthcare Systems, Inc. Robyn Ballard, Senior Technical Solutions Manager, OptumInsight, Inc |
|
| April 6th | 8:00am-8:45am States of Implementation Roundtable 1: Enabling State Medicaid MMIS and E&E Implementations Van Showell, IT Specialist, CMS Trish Heiman, MITRE Nick McNeil, MITRE Tim Peterson, Montana, MMIS Project Manager (TBC) |
1:30pm-2:30pm Track 1: CMCS Track 1 #4 The Open Source Provider Screening Module Eugene Gabriyelov, CMCS/CMS, Technical Director Trish Heiman, MITRE David W. Hill, The MITRE Corporation, Principal Software Systems Engineer James Vasile, Open Tech Strategies, Partner |
2:35pm-3:20pm Closing Keynote: The Role of States in Implementing the 21st Century Cures Act’ Speakers Thomas Novak, ONC/HHS, Medicaid Interoperability Lead, Office of Policy Genevieve Morris, ONC/HHS, Principal Deputy National Coordinator |
| April 6th | 8:00am-8:45am States of Implementation Roundtable 3: Poplin, A Reference Architecture for Medicaid Eugene Gabriyelov, CMCS/CMS, Technical Director David W. Hill, The MITRE Corporation, Principal Software Systems Engineer Andrew Laing, Agency of Human Services, State of Vermont, Director, Business Systems Architecture |
1:30pm-2:30pm Track 1: CMCS Track 1 #4 The Open Source Provider Screening Module Eugene Gabriyelov, CMCS/CMS, Technical Director Trish Heiman, MITRE David W. Hill, The MITRE Corporation, Principal Software Systems Engineer James Vasile, Open Tech Strategies, Partner |
2:35pm-3:20pm Closing Keynote: The Role of States in Implementing the 21st Century Cures Act’ Speakers Thomas Novak, ONC/HHS, Medicaid Interoperability Lead, Office of Policy Genevieve Morris, ONC/HHS, Principal Deputy National Coordinator |
Health Information Sharing Maturity Model
HISMM provides a common framework and incremental approach to improving Health Information Sharing (HIS) capabilities.
With respect to Medicaid IT, HISMM can support:
- State HIS and health information exchange planning
- Health information technology roadmap development
- Cross-state collaborations
- Key MITA objectives, including: adopting industry standards for data exchange; promoting efficient and effective data sharing to meet stakeholder needs; providing a beneficiary-centric focus; and promoting secure data exchange
HISMM consists of 11 maturity dimensions each assessable at one of five levels and 30 HIS capabilities relevant to Medicaid agencies, patients, and providers.
HISMM on zONE
The HIS Maturity Model is now available on the CMS zONE website. Interested State users can request access through the community tab on zONE.
If you are interested in learning more about the HISMM and performing an assessment, please contact Tom Novak at Thomas.Novak@hhs.gov.
Medicaid Information Technology Architecture Governance Board Update
Look for CMS draft updates to the MITA 3.0 Framework for public comments this summer.
Why should I care?
States will be expected to complete a MITA 3.0 State Self-Assessment within 12 months of the MITA 3.0 updates
Vendors can use the revised MITA framework to identify, build, and deliver capabilities necessary for state Medicaid agencies
What’s included?
How do I get information?
View further information related to the upcoming MITA release, or email MES@cms.hhs.gov?subject=mita_public_comment with questions.
**Special thanks to the MITA Governance Board and working groups for support in completing draft updates to the MITA 3.0 Framework***
Medicaid Module Precertification Pilot is Complete
To explore the precertification of Medicaid modules and its impact on the modularity vision for the MMIS ecosystem, CMS initiated a precertification pilot in October 2017. The pilot focused on two business areas—Pharmacy and Provider Screening—and was open to all vendors. The precertification pilot is now complete.
CMS thanks the six participating vendors for their hard work and collaborative approach in making the pilot a great learning experience. As indicated by the engaging vendor panel at the recent 2018 HIT Connect Summit, the opportunity to collaborate with vendors provided useful insights into the benefits, challenges, and impact of implementing a precertification program.
CMS will be sending vendors a final report that summarizes the extent to which the modules met the precertification criteria, key observations about their modules, and recommending opportunities for further development.
More information about the pilot’s findings and next steps will be shared at MESC 18. For more information, please sign up for the precertification listserv at module_precert@mitre.org or visit the Medicaid Vendor Module Precertification Program page.
MMIS Cohort: Join the Conversation
State IT leaders - were you able to attend the March MMIS Cohort meeting? On March 28, Ralph Lollar, Director, CMCS Division of Long Term Services and Supports, presented an overview of Section 12006 of the 21st Century CURES Act Provisions that requires States to implement an Electronic Visit Verification (EVV) system, which led to great interactive discussion. States must implement an EVV for Personal Care Services (PCS) by January 1, 2019 and for Home Health Care Services (HHCS) by January 1, 2023 to avoid a reduction in the Federal Medical Assistance Percentage. For additional information about the EVV requirement, suggestions for implementation, and current State practices, please see part 1 (PDF, 704.99 KB) and part 2 (PDF, 518.02 KB) of this EVV presentation.
Questions regarding the EVV requirement should be sent to Ralph.Lollar@cms.hhs.gov with EVV in the subject line.
In case you missed it, CMS invites State IT leadership to join the MMIS Cohort on the last Wednesday of every month from 2-3 pm ET. What is the MMIS Cohort?
- An interactive monthly discussion geared around key topics of interest, such as States' modular certification experiences and preliminary results of the precertification pilot
- A chance for States to share experiences and challenges and identify opportunities to collaborate with one another and/or with CMS toward actionable solutions
- An opportunity to hear “sneak peeks” and provide State feedback on upcoming CMS initiatives
At our 2018 kickoff, States received answers to their questions on the precertification pilot as well as the Open Source Provider Screening Module.
To be invited to the next MMIS Cohort meeting on April 25, please email Van Showell (van.showell@cms.hhs.gov).
MES FAQs
Q: CMS has released 90/10 funding in order for States to improve their eligibility systems for Medicaid. Will that funding continue?
A: Yes. Both the "90/10" funding for Medicaid eligibility (E&E) system design and development, and the enhanced 75 percent matching rate for maintenance and operations of such systems, will be available indefinitely as long as the systems meet applicable program requirements.
