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Upcoming Procurement Data

General Information
Solicitation Title:  MMIS Takeover RFP
Agency:  Human Services
Existing Contract Number:  4000013930 and 4000022569 
Proposed Solicitation Date:  09-01-22
Contract Expiration Date:  10/31/2023
Proposed Method of Procurement:  
Description:  At the core of the current Pennsylvania MMIS is the PROMISe system, an enterprise-wide system which provides automated support for Pennsylvania’s Medical Assistance program and other Commonwealth programs.  The PROMISe system was developed in 2004 and is designed to support both the fee-for-service and managed care delivery systems as well as the Department’s various waiver programs. The Offeror will provide a wide range of services including front-end claims and encounter imaging and capturing (hardcopy and electronic), claims resolution, eligibility verification using the Eligibility Verification System (EVS), Automated Voice Response System (AVRS), Electronic Visit Verification (EVV), on-line pharmacy claims capture and adjudication including Prospective Drug Utilization Review (ProDUR), drug rebate processing, Provider and User Assistance Center for technical support, provider and external user training, plastic Medicaid identification (ID) card production, a Fraud and Abuse Detection System (FADS) to support the surveillance and utilization review (SUR) functions, interfaces with numerous external entities, and  several Web applications.  It is anticipated that FADS will be replaced prior to the release of the RFP.
The Offeror selected to takeover the Pennsylvania MMIS will be required to transfer this system and be operational no later than November 1, 2024. The Offeror will then operate, maintain and modify the system during the contract, culminating, as applicable, with the Offeror’s own transition and turnover of the system.

Review Information
Issuing Office:
Human Services
Contact Person: Eric McCoy
Contact Email: