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Modernizing medicaid in Middle America

Client

The Ohio Department of Medicaid (ODM) delivers healthcare to more than 2.9 million residents. Working closely with stakeholders, advocates, medical professionals, and fellow state agencies, the agency continues to find new ways to modernize Medicaid in Ohio.

Challenge/Opportunity

Ohio is one of the first states to procure and implement a modular Medicaid Enterprise System (MES) including new CMS certification requirements, and is the first state to undergo CMS certification for its Electronic Visit Verification (EVV) module. The Department sought to obtain independent validation and verification (IV&V) services through the procurement, design, development and implementation, and continue through maintenance and operations of their new modular Ohio Medicaid Enterprise System (OMES).

Solution

BerryDunn represents the interests of CMS and provides an independent oversight and an unbiased perspective on the procurement, design, and development of the OMES to help ensure the integrity and functionality of the system. BerryDunn is involved in each step of the project lifecycle to:

  • Support reconciliation of the  legacy MMIS system to the OMES
  • Offer guidance to help ensure requests for proposals meet the needs of the state  
  • Monitor compliance with CMS guidelines
  • Assess overall project health by immersing ourselves in the project and monitoring scope, schedule, quality, and resource management
  • Provide CMS certification support and review based on MECT 2.3 guidelines

Outcome

Ohio is the first state to complete CMS certification activities for its EVV module. Ohio has also successfully completed CMS R1 certification for provider. ODM has procured a Systems Integrator and is in the process of procuring its Provider, Finance, and Claims modules. Our team offers guidance and feedback to help address potential risks and issues. 

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