Many people have asked whether a service-based model for Medicaid
Management Information System (MMIS) qualifies for enhanced federal funding. The answer is yes.
As you know, the federal government requires states to undergo certification to receive enhanced Federal Financial Participation (FFP), which pays 90 percent for MMIS implementation and 75 percent for ongoing operations. What you may not realize is that if you purchase simply the MMIS business services, you can receive the same MMIS-related enhanced federal funds you would have had you purchased an MMIS system.
How to secure enhanced FFP for the services-only approach
Securing Centers for Medicare & Medicaid Services (CMS) approval is similar to current practice, except you structure your needs in the form of business services instead of system requirements. This is how the process works:
- The state submits an Implementation Advanced Planning Document (IAPD), and upon approval from CMS, issues an RFP containing its business service requirements.
- Following system implementation, CMS auditors will seek to certify that all business services required by the RFP and approved by CMS have been implemented and made available.
- Once certified, enhanced FFP consistent with the rates available for certified MMIS implementation and operation will be made available to the state.
To read more about new ways to tackle your MMIS, download our white paper on modern-day alternatives to MMIS procurement practices and read the opinion paper on this approach by Covington & Burling LLP, a Washington, D.C.-based law firm with extensive experience in public policy.