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Wyoming making moves on health insurance exchange efforts

The Wyoming Department of Health, the agency responsible for administering Medicaid and the Children’s Health Insurance Program (Kid Care CHIP), released a request for proposals (RFP) last week for a Health Insurance Eligibility and Enrollment System (HIEES). The main objective of the procurement is to enhance the state’s current integrated eligibility system, Eligibility Payment Information Computer System (EPICS), and improve integration with the state’s future insurance exchange. EPICS is the state’s legacy system and was adopted from Alaska’s system architecture in 1986. More specifically, the new solution will replace the Medicaid component of EPICS and consolidate Medicaid and Kid Care CHIP into a single system. This will enable the state to support health insurance programs more effectively.
Proposals for the HIEES solution are due on June 15. The system is expected to support real-time electronic application and eligibility determinations for all health insurance programs administered by the agency. Wyoming’s Kid Care CHIP program processes about 800 applications and renewals monthly.
The following are the department’s identified project goals:
  • Select and secure a qualified vendor to design, develop, configure, implement and maintain a new eligibility and enrollment system to support state health insurance programs.
  • Procure all major HIEES components including a public-facing client Web portal, EDMS, and flexible architecture that is scalable and able to accommodate future state and federal needs. 
  •  Include necessary functionality and support to assist the state in fulfilling ACA requirements by the agreed-upon project milestone dates.
  • Meet or exceed federal enterprise architecture and security certification standards and the CMS Seven Conditions and Standards required for enhanced federal funding.
Wyoming is one of many states that recognizes a need to replace and/or enhance current eligibility system infrastructure. It is inevitable that both systems will need the capability of sharing information and talking to one another. For that, vendors can expect to see similar procurements released more frequently as the deadline for the insurance exchange nears.
As always, be sure to follow Deltek’s Health Care and Social Services Team on Twitter@GovWin_HHS and LinkedIn!

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