Specifications include, but are not limited to: The Nebraska Department of Health and Human Services (DHHS) is issuing a request for information to inform the planning, design, development, and implementation of the State’s Medicaid Enterprise System (MES) modernization and optimization strategy. Nebraska seeks to develop a strategy and roadmap that focuses on modularity, Return on Investment (ROI), opportunities for reuse, and value for the Medicaid beneficiary. The first priority for Nebraska is replacement of the State’s incumbent Data Management and Analytics (DMA) solution. This legacy system includes multiple modules, and serves the following key functions for the State: • Managed Care Organization (MCO) encounter claims processing, acceptance, and validation; • Medicaid Data Warehouse and Analytics; • Pre-built and ad-hoc reporting, including federal financial reporting; • Transformed Medicaid Statistical Information System (T-MSIS) reporting; and • Program Integrity Case Management (PICM) platform used for Fraud, Waste, and Abuse investigations (FWA), and Fraud Detection and Analytics reporting.
