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Solicitation Title:
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Prior Authorization & Outbound mail Modules for the MMIS 2020 Program
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Agency:
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Human Services
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Existing Contract Number:
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Proposed Solicitation Date:
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05/18/18
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Contract Expiration Date:
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Proposed Method of Procurement:
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Description:
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Pennsylvania will purchase a modular Medicaid Management Information System (MMIS) (known as MMIS 2020) to replace its PROMISe system at the conclusion of its current contract with Hewlett Packard Enterprise (HPE) in October 2017. DHS will purchase a module that will support all prior authorization (PA) processes for services including outpatient drugs, dental, and medical services, and will allow providers to request PAs and e-prescribe from mobile devices via a web portal. This module will also support intense case management and process program exceptions. The PA module is one of several modules to be procured for the MMIS 2020 Program. DHS’ vision is to have a PA module that automates PA functions that are HIPAA compliant (to maintain Pa’s eligibility to receive FFP), contain a rules based processing system, and support case management (CaseNet TruCare contract ends in 2017), and process program exceptions
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