Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsUse of Business Rules Engine. Team Noridian's solution for IME includes RuleIT, a rules engine basedon industry standards and built specifically to address the Medicaid program. RuleIT, in its fourthversion, has been refined and performance-engineered in real-life production to meet the high demand ofa Medicaid enterprise. The use of a rules engine is becoming a standard requirement for new MMISimplementations; however most adoptions of rules engines are not robust. eCAMS has adopted the rulesengine from its inception and has matured its implementation across three successful deployments.eCAMS has now made the utilization of RuleIT universal across core business processes and has finetunedits implementation approach to minimize implementation risk and maximize compliance withfederal and state guidelines. An additional benefit the new MMIS provides the Department is, throughEXACT's Integration Services, the RuleIT engine can be shared by other services or made available as aservice across the enterprise, based on requirements.Submission of Business Rules to a HHS-Designated Repository. Team Noridian will use the RuleITengine reporting features to submit all business rules in human readable form to any HHS repository. Wewill follow the guidelines for submission of the rules and comply with CMS requests for additionaldetails and specifications. We will work with IME to identify the specific rules that need to be protectedfrom distribution (e.g. those that protect against fraud) and communicate that to CMS.MITA ConditionTeam Noridian has monitored the evolution of MITA from version 1.0 to its current version 2.0 andcontinue to monitoring the evolution of the next version MITA 3.0 due in 2011. eCAMS core principlesof modularity, open standards, and especially its business-driven architecture enables its alignment withthe MITA direction. eCAMS is evolving to support adoption of the harmonized standards around healthinformation exchange (HIE) as the Medicaid program becomes a key component of the health careframework. As an example of Team Noridian's real world commitment to MITA alignment, the newMMIS, through EXACT's orchestration services can ingest the new version 3.0 artifacts, therebyaccelerating the Departments compliance with the standards.MITA Self Assessments. Team Noridian will assist IME in performing a self assessment using the finalversion MITA 3.0 within 12 months of the implementation.MITA Roadmaps. Team Noridian will work with IME to develop a MITA roadmap. The roadmap willdemonstrate how we plan to improve in MITA maturity over the 5-year period and our anticipated timingfor full MITA maturity. The roadmap will contain a sequencing plan with considerations of cost, benefit,schedule, and risk.Concept of Operations (COO) and Business Process Models (BPM). Team Noridian will work withIME to streamline and standardize these operational approaches and business work flows to minimizecustomization demands on technology solutions and optimize business outcomes. The goals to develop aconcept of operations and business work flows for the different business function of IME will be readilysupported by the eCAMS platform. This will aid IME in advancing the alignment of the MMIS capabilitymaturity with the MITA Maturity Model (MMM). The eCAMS core architecture leverages the EXACTSOA framework to be able to effectively integrate into disparate systems. The architecture provides anintegration backbone that connects core applications and services without directly accessing theunderlying systems. The eCAMS architecture is based on leveraging a series of COTS products that use aservices-based integration platform. eCAMS relies on open standards and standard application programinterfaces (API) for plug-ability of third-party communities such as the Java Business Integration (JBI)standard. The eCAMS architecture leverages the open source–based EXACT Integration Servicees as thecore orchestrator tool of business processes across the different applications that support Medicaidoperations. The EXACT SOA framework will be the basis of the infrastructure and will eliminate orreduce point-to-point communication between different system components.9 | 17