Medicaid Current Initiatives

 
2
Medicaid Related Assistance
Medicaid & Long-Term Care
 
No
No

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What you need to know

Medicaid Electronic Health Record (EHR) Incentive Program

Medical Assistance Advisory Committee

The Department is required by federal law to establish a Medicaid Assistance Advisory Committee (MAAC) to advise the Medicaid director about health and medical care services. The regulations describing the committee may be found at 471 NAC 1-004.01. Members are appointed by the Medicaid director.

To become a member of the committee, or to request additional information, please contact Roxie Anderson at roxie.anderson@nebraska.gov.

Resources

MAAC Bylaws

Medicaid Management Information System (MMIS) Replacement Project

Background

The Medicaid Management Information System (MMIS) is made up of different parts and helps support Nebraska's Medicaid program. It processes and monitors claims, helps coordinate benefits, creates federal and management reports, and provides case management tools.

The federal government certified Nebraska's current MMIS in 1978. Though it has served Nebraska well, it is becoming difficult to maintain due to its age. DHHS has begun to the replace the MMIS piece by piece, with a “modular approach."

The launch of new Medicaid managed care programs in 2017 has reduced the volume of claims MLTC processes in house and has allowed the Division to consider alternate solutions for processing the few remaining fee-for-service claims. 

Current Work

The current priority for the MMIS replacement project is the Data Management and Analytics (DMA) solution, which is currently under development. In February 2018, MLTC began work to implement a DMA solution that includes a data warehouse, decision support, program reporting, federal and ad-hoc reporting, management and administrative reporting (MAR), surveillance and utilization review (SUR), and fraud and abuse detection (FAD) case management. The DMA project is expected to launch in June 2019 and will help the Division work as a data-driven organization.

MLTC intends to contract with external vendors for the remaining parts of this modular approach through requests for proposals (RFPs). Central Provider Management, Pharmacy Point of Sale, and Medicaid Drug Rebate are slated for procurement in the future. MLTC will also pursue the tools and technology to integrate new MMIS modules.

All RFPs are published by the Nebraska Department of Administrative Services.

Please send questions about the MMIS Replacement Planning project to DHHS.MMIS@nebraska.gov