Thumbs up for Massachusetts’ Medicaid IT

System to process 80M claims a year

SPRINGFIELD, MA – The Centers for Medicare & Medicaid Services has fully certified the Massachusetts’ Medicaid Management Information System (MMIS). The accreditation ensures the state will receive maximum federal funding for the system’s implementation and ongoing operation.

HP designed and built the system. The Massachusetts certification marks the 10th HP interChange MMIS to earn federal accreditation, said Bill Ritz, spokesman for HP.

“The beauty of this system is it allows almost all of the Medicaid claims in Massachusetts to be submitted electronically,” Ritz said. “What would happen if you had to put all the claims in by paper?”

The new system processes approximately 75 million eligibility verifications and 80 million claims a year from the state's 24,000 Medicaid healthcare providers, according to HP. The claims are worth $6.5 billion per year.

“The federal certification of Massachusetts’ MMIS is the result of hard work and collaboration by the Office of Health and Human Services and HP,” said Julian Harris, director, Massachusetts Medicaid. “The system we implemented is user friendly and efficient, benefiting Medicaid providers and citizens across Massachusetts.”

Sara Hartman, vice president, Association of Behavioral Healthcare views the new Massachusetts Medicaid claims system as a valuable resource for Medicaid providers such as her organization.

“It brings the claim system into the 21st century, supporting the business practices of the behavioral health providers, the efficient and timely payment of claims, as well as the increased compliance with state and federal regulations,” she said.

HP bills itself as the nation’s largest provider of Medicaid and Medicare process management services, administering $95 billion in benefits a year. It serves as the fiscal agent or principal IT provider for Medicaid in 21 states, according to Susan Arthur, vice president, U.S. Healthcare, HP Enterprise Services.

“As states prepare for the entry of millions of new Medicaid patients into the system over the next few years, they are looking for flexible, yet powerful information systems to ease administrative and provider workloads,” Arthur said.