Cabinet for Health and Family Services Office of

Cabinet for Health and Family Services Office of Administrative & Technology Services Division of Medicaid Systems Medicaid Enterprise Management System (MEMS) RFP Pre-Release Vendor Conference 12 Mill Creek Park, Frankfort, KY 40601 Tuesday, 10/21/2014 10: 00 – 11: 00 am

Kentucky Medicaid Enterprise Management System RFP Pre-release Vendor Conference Discussion Outline Ø Welcome to Kentucky and Introductions Ø Kentucky’s Quality Health Information Ø Medicaid Enterprise Management System RFP Scope of Work Ø Individual Vendor Conference Ø Open Comments and Feedback Cabinet for Health and Family Services

Kentucky’s Quality Health Information (QHI) Ø Kentucky has developed a complete and achievable e. Health IT Architecture. Ø Kentucky has a consolidated Cabinet organization that encompasses all of the program pillars depicted in our vision. Ø CHFS Secretary Haynes and Governor Beshear have been engaged and aggressive in our efforts to improve healthcare in Kentucky and nationally. Ø Early adoption of HIE, GOHIE, HBE, etc. Ø Focus on improved delivery and quality of healthcare through Managed Care and push to streamline MMIS. Cabinet for Health and Family Services

Kentucky’s QHI Components for CHFS Supported Systems: Ø Citizen, Worker, Partner Web Portals Ø Share. Point Document Management System Ø Corticon Business Rules Engine Ø Biz. Talk Enterprise Service Bus Ø IBM Infosphere Master Data Management Ø SAS Fraud Framework Ø KOG (Kentucky On-line Gateway) Seamless Security Services Ø HP Exstream Fulfillment Service Ø K 2 Blackpearl Workflow Management Cabinet for Health and Family Services

MEMS RFP Scope of Work There is only 1 option: The CHFS, Department for Medicaid Services (DMS) is seeking a Vendor(s) to provide Software as a Services (Saa. S) solution for the Kentucky MEMS Claims Processing and Fiscal Agent (FA) services, as well as DDI for Encounter Processing and a Decision Support System/Data Warehouse (DSS/DW) hosted by the Vendor. There are no “options to buy”. Cabinet for Health and Family Services

MEMS RFP Scope of Work The Commonwealth requires that the future Medicaid Enterprise Management system be built using the following principles: Ø Seamless data exchange of information with QHI framework including real-time integration with Kentucky Health Benefits Exchange System. Ø Optimization of Managed Care Relationships and streamlined support for remaining Fee for Service processes. Ø SOA based solution comprised of components that integrate into the Commonwealth’s SOA framework or directly utilizes the Commonwealth’s components. Ø MITA based modular solutions from a single Vendor or a “best-of-breed” multi-vendor solution. Ø Meets CMS certification requirements as defined in the CMS MECT. Ø Comprehensive data management strategy that organizes all of the data and enables easy access to information. Ø Configurable and extendible solution to cost-effectively support Kentucky’s future expansion of programs and populations, and to meet current and future regulatory needs. Cabinet for Health and Family Services

MEMS RFP Scope of Work Not in RFP Scope: Ø Utilization Management (UM) Services Ø Pharmacy Benefit Management Cabinet for Health and Family Services

Individual Vendor Conference Ø Vendors will have the opportunity to submit written comments, suggestions and recommendations concerning the RFP. Ø Vendors will have the opportunity to schedule an individual conference with representatives from CHFS and the Finance Cabinet to discuss your Vendor’s written comments and suggestions, prior to the issuance of the RFP. Cabinet for Health and Family Services

Questions Open Questions and Feedback Cabinet for Health and Family Services