I’m helping PS-TG put together presentations for the MMIS Conference in August.

You are invited to submit an abstract of a proposed topic to be considered for presentation at the upcoming MMIS conference. Don’t miss this unique opportunity! The MMIS Conference attendees include IT and health care professionals from Medicaid agencies as well as CMS and the government services sector of the health care vendor community. There are numerous benefits to being a speaker, including:

• Your name and State or company name included in conference promotional materials related to speaker session(s)

Please do not contact me with questions about this RFP. I’ve posted this link as a courtesy, since I know people often visit my site looking for information about MMIS RFPs. The purpose of this RFP is to receive proposals from qualified vendors wishing to provide services required by Florida Medicaid to design, install, and operate a Medicaid Management Information System, Decision Support System, and fiscal agent services. The Medicaid Procurement Library is available from the Agency upon request. The RFP is available on paper and electronically on CD-ROM upon request. A Vendor Conference has been scheduled for 1:30 PM, March 23, 2005, at 2727 Mahan Drive, Building 3, Conference Center, Tallahassee.

Connecticut has a tentative schedule for releasing their Medicaid MMIS RFP in March 2005. Maximus is assisting them with the MMIS procurement. CT MMIS Procurement Schedule

I attended the PS-TG meeting last week. It was held in conjunction with the NASMD Annual Conference in Washington, DC. The PS-TG is an industry group for Medicaid vendors. I’m running for Secretary.

Membership is only $50. I encourage all vendors interested in providing services to Medicaid programs to join. I’m encouraging the group to create a committee on Fraud that will address Program Integrity, SURS, Prior Authorization, Audit, eligibility and provider verification, and other issues related to fraud. Join now, so you can help Medicaid programs get the best services and products available.

September 2004 Texas announced that they had increased Medicaid Fraud Control Unit (MFCU) staff from 36 to 110, and expect to increase to at least 200 by the end of fiscal year 2005. In FY 2004 the MFCU doubled the number of cases it opened, the number of cases presented for prosecution and the number of cases in which criminal charges were filed. Identification of illegal overpayments made to fraudulent operators has increased by 85 percent to over $27 million. Last month the U.S. Department of Health and Human Services recognized Texas by awarding them the annual Inspector General’s State Fraud Award.

Everything I Ever Really Needed to Know about Healthcare Data I learned the Hard Way

I started my career as an analyst for Indiana Medicaid. We had no data. We had a file cabinet full of reports on microfiche, but that did not become data until I compiled it into a useful format. Having spent half my career as a Medicaid employee in charge of data analysis and the other half working for or with decision support vendors, I’ve particpated in a lot of implementations from both sides of the table. Here are some of the lessons I’ve learned:

1. Getting the right information to the right people at the right time is all that matters. Ultimately, the decision support system and data warehouse only exist to help manage the healthcare system. RFPs and proposals focus on delivering a certain number of reports in a certain way. This helps the bidders propose prices that are comparable. It does not help the client get value. I’ve spent months with clients making sure they get their 50 reports. They want me to create 70 reports, then let them pick the best 50. Instead, we should both be focusing on meeting their needs. Can they find fraud, monitor the budget, maintain access to care, improve quality and evaluate policy changes? If not, we’ve failed, whether they have 50 reports or 2,000.

Does more medical spending result in better health? Researchers knew that differences in medical spending between regions (which vary by as much as 200%) are not explained by differences in prices, nor differences in health or socioeconomic status. Instead, they are related to differences in the quantity of medical services provided and in the number internists and specialists.

Medicaid programs cannot run on autopilot for long before growth in expenditures exceeds the growth in tax revenue. To keep your Medicaid program on track: 1) diagnose the underlying problems causing high growth rates, 2) choose methods of reform that address those problems, 3) implement reforms, 4) monitor the results of the reforms, and 5) fine tune your policies to make midcourse corrections.