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Florida awards $172M Medicaid contract to HP

By Mike Miliard , Executive Editor

Will help transition to managed care, combat fraud and abuse

PALO ALTO, CA – HP Enterprise Services announced the Florida Agency for Health Care Administration (AHCA) has signed a renewal service agreement to manage the state's Medicaid Management Information System. The $172 million, three-year extension will help the state transition to a managed care environment.

Through its interChange Medicaid Management Information System, HP has provided fiscal agent support and business process outsourcing services to AHCA since 2008. HP is helping the agency prepare for pending healthcare changes by assisting it through the mandatory managed care transition, implementing federal HIPAA 5010 requirements and supporting the move to ICD-10.

"The agency appreciates the expertise HP contributes as a valuable member of our team," said Elizabeth Dudek, secretary of AHCA. "The agency looks forward to continuing our good working relationship as we move forward with transition and implementation of several key initiatives."

Since AHCA switched to the HP interChange Medicaid system, the company has implemented Web-based provider enrollment, claims authorization and file exchange, as well as supported various agency initiatives such as Medicaid reforms, the National Correct Coding Initiative to support claims coding standards and the EHR incentive program.

HP has also implemented a decision support system that increases productivity and lowers costs while providing better support for health-policy decision-making. The system gives staff access to secure data to more thoroughly analyze the agency's programs and policies and to help reduce fraud and abuse.

HP plans to enhance Florida's federally certified interChange MMIS with new advances. From its facilities in Tallahassee, Fla., HP provides real-time claims processing, call center services and claims suspense and it oversees pharmaceutical support provided by a third party.

HP helps Florida manage Medicaid benefits for more than 3.1 million Floridians. The company processes more than 150 million claims worth more than $20 billion a year for about 114,000 Florida healthcare providers.

"As a state with one of the largest and most complex Medicaid programs, Florida needs the flexibility to address future issues including increases in demand and regulatory changes without service interruptions," said Susan Arthur, vice president, U.S. Healthcare Industry, HP Enterprise Services. "HP built and manages a system for Florida based on the most advanced and proven technology to streamline Medicaid procedures while providing the state with vital information about healthcare trends and the medical needs of Florida's Medicaid beneficiaries."