| Louisiana Department of Health |
Medicaid-MMIS |
Application that includes Title XIX program control and administrative costs; service to recipients, providers and inquiries; operations of claims control and computer capabilities; and management reporting for planning and control. There are several modules within MMIS including provider management, FFS pharmacy benefit management, and is the fiscal intermediary for Medicaid claim submittal.
The Medicaid Management Information Systems (MMIS) Division administers the contract and monitors the budget of the Medicaid Fiscal Intermediary (Molina), which is responsible for the payment of claims to providers and the timely and accurate reporting to state and federal personnel and private sector partners.
The current MMIS is outdated and inefficiencies exist as it is difficult to implement changes and impacts CMS funding to maintain an aging and ineffective system. In addition, CMS is not investing any additional resources into changing/upgrading MMIS as it stands today. |
In-Progress |
4 - Devastating Impact |
Medicaid payments in excess of $8.3B including other financial impacts such as the loss of rebates on prescription drugs to the State are at risk with the failure of MMIS. |
The failure of MMIS has far reaching impacts including Medicaid recipients being denied services due to non-payment to participating doctors and pharmacies. MMIS processes 51 million Medical claims annually for more than 30,000 Medicaid providers. |
Key |
100M-150M |
|
OEPT-527 |
| Louisiana Department of Health |
OBH-TANF (Temporary Assistance to Needy Families) |
This application is for temporary assistance to needy families (TANF). The providers use the system to input data for rollup reports and for submitting invoices for monthly payments from OBH. Generally speaking, without the system LDH could not report to the funding source (DCFS) and could not provide documentation for reimbursement. This will interfere with OBH’s ability to be reimbursed from the funding source (DCFS). The money has already been IAT (Inter Agency Transferred) to the LGE (Local Government Entity) so the system does not interfere with their reimbursement. |
Not Started |
3 - High Impact |
If this system were to go down, OBH could not report out to their funding source (DCFS) and could not provide documentation for reimbursement for submitting invoices of monthly payments from OBH that total approximately $215,000 to $235,000 per month. |
The TANF providers will not be able to report out on performance indicators outlined in their respective contracts as they currently assist around 94 families. |
Normal |
49K-100K |
|
OEPT-646 |
