Christine Jordan Sexton
Before the state launches a Medicaid managed care re-procurement at the end of the year, it wants to have negotiations for three Medicaid information technology contracts estimated to be worth more than $320 million signed and in place.
The state wants to rebuild the current Medicaid Management Information system with a new modular Medicaid management information system it’s calling Florida Health Care Connections (FX).
Florida Politics has requested the names of the vendors that responded to the three invitations to negotiate. The Agency for Health Care Administration (AHCA) replied to two of the three requests by press time Wednesday.
According to the agency, five vendors submitted responses to the ITN for the provider service module, a seven-year contract worth an estimated $33 million. They are: Gainwell Technologies; Optum; HHS Tech Group; FEI Systems; and Digital Harbor Inc.
The provider service module would be used by all Medicaid providers, regardless of the type of care provided. The module must allow for concurrent processing of enrollment and plan credentialing activities for both initial enrollments as well as renewals.
Six vendors submitted bids for the unified operations center module. They are: Conduent State Healthcare; Gainwell Technologies; Deloitte; Automated Health Systems TTEC; Cognosante; and Maximus. The seven year-contract is worth an estimated $139 million.
AHCA had intended to have those two ITNs closed by now but twice has had to push back the award announcement to continue negotiations. The newest timeline has the state announcing the winner of those contracts on June 30.
The third ITN the agency will award is for so-called core systems and is expected to be worth $154.5 million. AHCA has not provided Florida Politics with the names of the vendors that submitted responses to the third ITN by press time. The latest timeline shows AHCA wants to award that contract by July 8.
Currently, the Medicaid management information system is a single integrated system for claims processing and information retrieval. But AHCA wants to transform that into a modern modular system that connects with other data sources and programs.
AHCA Secretary Simone Martsiller told lawmakers last year her agency needed nearly $118 million to fund the three ITNs in the coming year. Ultimately the Legislature approved $112 million instead.
The state intends to begin what can be a lengthy procurement process for the Medicaid managed care program toward the end of the year. This will be the third time the state has competitively bid the Medicaid program.
With re-procurement a top priority, AHCA lobbied the Legislature during the 2022 session to make changes to the state law intended to streamline the procurement process for the state. The Medicaid managed care contracts are the most lucrative in the state, worth tens of billions of dollars to each winning managed care plan.
