Medicaid Management Information System (MMIS)

The California Medicaid Management Information System (CA-MMIS) is a large, complex statewide IT project chartered to replace the existing 30+ year old legacy system for Medicare/MediCal claims processing.   It is in the process of being updated to a suite of modern and scalable software applications that will enable the state to increase operational efficiencies, and to support the Department of Health Care Services (DHCS) strategic objectives.   The Project has also adopted an Agile software development methodology, and is currently in transition to utilizing a Scaled Agile Framework (SAFe).

For years, The Ballard Group team has been involved with MMIS testing for several states, including test oversight and IV&V at CA-MMIS to protect the State of California’s interests.  This oversight has included providing timely, accurate, and insightful assessment of all aspects of test planning and design, detailed test design specifications, and test plan implementation and ongoing assessment.  We understand how MMIS systems operate, and the subtle complexities involved.  If you are implementing the extensive system changes required to support the Medicaid extensions associated with the ACA, for example, our MMIS experience would enable us to immediately contribute to your team.   Of course, ICD-10 End-to-End (E2E) testing would also benefit from our deep understanding of MMIS.  Although relatively few claims submitters will be chosen to do full E2E testing with CMS prior to the October 2015 deadline, E2E testing will surely be required related to any problems encountered after the cutover.  

The Ballard Group can help you prepare for all of these challenges now.