Nebraska Medicaid Program

Current Initiatives

MMIS Replacement Project

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The Medicaid Management Information System (MMIS) is comprised of functionality within a number of systems that provide support for the administration of Nebraska’s Medicaid Program. The MMIS processes claims, supports coordination of benefits, assists in surveillance and utilization review of claims payments, generates federal and management reporting, and provides case management tools.

The federal government certified the current MMIS in 1978 and, although it has satisfactorily met its original objectives, it has become increasingly difficult to maintain and enhance because of outdated technologies in the automated application. Efforts to enhance the system over the past decade have improved some of the Medicaid Program operations.

Recognizing the need to implement new technology, and with the support of the Legislature, DHHS has embarked upon the planning phase of replacing or enhancing the MMIS functionality.  Appropriate project planning, preparation and involvement of experienced resources are key to positioning Nebraska for success in this large IT project. The new solution will likely be in place for quite some time, and as such, ensuring the solution meets not only today’s needs, but those in the future, is paramount.  As such, it is imperative the project be well thought out and planned accordingly to reduce risks by building upon our strengths and minimizing weaknesses.

The project team is currently performing the strategic planning analysis necessary for a fundamental implementation of this size.  The strategic planning analysis will include three parts:

  • Alternatives Analysis – Conduct analysis on various models for replacing or enhancing the MMIS to meet Medicaid administrative needs.
  • Market Analysis – Gain market understanding to make informed decisions.  During this project phase, the team will focus on:
    • Understanding what current solutions and capabilities are available.
    • Identifying approaches and lessons learned from other states.
    • Facilitating interaction with providers to address feedback and opportunities for improvement.
  • Procurement Analysis – Determine the most appropriate procurement strategy to obtain the expected solutions.

A high level schedule of the project activities can be accessed at the following link:

MMIS Replacement Estimated Planning Project Timeline

DHHS conducted vendor demonstrations of MMIS solutions as part of the market analysis effort to increase understanding and awareness of available functionality within the marketplace. DHHS is expanding the information gathering process of the market analysis by further refining business functionality needs, particularly in the areas of data, program integrity, and analytics/reporting.

Vendor demonstrations, to understand technology available in these areas, may be conducted in the future.

Obtaining Medicaid provider input is critical to the success of the project.  Surveys are being sent to providers who will utilize the new system to obtain feedback on system features important to them.  For more information on the surveys, please submit an inquiry to the email address indicated below.

For questions regarding the MMIS Replacement Planning Project, please send an e-mail to DHHS.MMIS@nebraska.gov.  More information will be published as it becomes available.

 


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