EDS scores Medicaid contracts with two states

Oklahoma Health Care Authority

Oklahoma has extended its Medicaid Management Information System (MMIS) contract with EDS, while Florida recently announced it intends to award an MMIS contract to the company.

Oklahoma Health Care Authority officials recently awarded a three-year extension worth $59.1 million to EDS for processing health care provider claims and providing hardware and software upgrades. The contract will extend the existing seven-year deal through 2010 as EDS transitions the system to an enhanced user interface.

EDS will continue to provide numerous services to the state, including claims processing; application development and maintenance; systems management; help desk support for both provider inquiries and client requests; provider relations and recruiting; clinical case management; data analysis and data warehouse support; data center and output operations; and pharmacy services.

Last year, the company processed more than 31 million claims for Oklahoma, distributing almost $2.7 million in Medicaid benefits for more than 600,000 low-income patients. More than 25,000 health care providers participate in the program.

EDS also will migrate Oklahoma’s system to the company’s interChange system, which uses Microsoft .NET technology to rapidly provide the capability to build, deploy, manage and use solutions with Web services, according to a company press release.

Officials from Florida’s Agency for Health Care Administration (AHCA) intend to award EDS a five-year contract beginning July 1, 2007, to manage the state’s 15-year-old MMIS. EDS beat out Unisys and Affiliated Computer Services (ACS), which currently holds the state contract.

According to AHCA spokesman Jonathan Burns, the original MMIS contract with ACS ran from July 1999 through June 2004 but was extended to June 2007 to accommodate system changes for the implementation of transactions and code sets required under the Health Insurance Portability and Accountability Act of 1996.

Florida officials said the new Medicaid system will include Web portals for providers and recipients so they can better navigate the system, file and reconcile claims, measure outcomes, and report fraud and abuse.

“New and more effective technologies are a critical part of the effort to transform Florida Medicaid,” AHCA Secretary Alan Levine said in a press release. “This new contract will form the foundation for an effective medical encounter data system, while allowing us to better measure patient outcomes and empowering Medicaid participants to assume a more active role in the care they receive.”

AHCA expects to save more than $20 million annually over five years under the new contract. Currently, the agency pays ACS about $66 million per year to administer the $14 billion program. According to a state press release, the state will pay about $38 million to EDS for the development of the new system and then $43 million annually to administer it. Federal funding will cover 90 percent of the development costs and 75 percent of annual operations costs. Florida’s Medicaid system processes about 140 million claims per year.

“We’re excited by the state’s decision and look forward to serving the taxpayers and providers of Florida,” said EDS spokesman Bill Ritz, who declined to give further details because the contract is being negotiated.

EDS manages Medicaid information systems for 19 state governments.