SOURCE: CNSI

September 09, 2008 08:30 ET

CNSI Awarded Two-Year Extension of Maine Medicaid Contract

Maine Claims Management System (MECMS) Demonstrates Efficiencies Over State's Legacy System

ROCKVILLE, MD--(Marketwire - September 9, 2008) - CNSI, a provider of innovative IT business solutions for government and commercial enterprises, announced it has signed a $10.5 million, two-year contract extension with the Maine Department of Health and Human Services (DHHS) to provide ongoing operations and maintenance services for the Maine Claims Management System (MECMS).

Under the extension, CNSI will continue operations support of MECMS through 2010 while the state transitions from a state-operated Medicaid management model to an outsourced fiscal agent (FA) model. States are increasingly taking (more than half of the states today have implemented an FA model) this approach primarily because staffing and infrastructure requirements make it difficult to operate these large, complex Medicaid Management Information Systems (MMIS) in-house.

"DHHS is pleased to extend our partnership with CNSI to continue the operations of MECMS for the next two years," said Brenda Harvey, commissioner, State of Maine DHHS. "DHHS appreciates CNSI's continued commitment to the State of Maine while we transition to a new fiscal agent operation."

The contract extends a long relationship between CNSI and DHHS, which involved a complete replacement of Maine's mainframe-based MMIS. Maine retired its 27-year-old legacy system in 2005 and replaced it with CNSI's next generation, J2EE-compliant MMIS.

In terms of efficiencies, MECMS is working far better than the legacy system. Today, MECMS processes approximately 10 million claims per year on average at an auto-adjudication rate between 91-96 percent, which exceeds the 70 percent rate for Maine's legacy MMIS as well as most of today's state and commercial payer systems.

In a June 19, 2008 public communication to Maine's Medicaid provider community, Kirsten Figueroa, deputy commissioner for finance, DHHS, stated, "In the last two weeks, we have experienced an unanticipated volume of claims submitted. Due to improved MECMS functionality, we have been able to process those claims resulting in $25MM more in paid claims above the anticipated $39.6MM weekly average."

"CNSI's recognized strengths were continuously brought to the forefront during the MECMS project. Over the years, CNSI worked diligently to move beyond system constraints and implement additional functionality, never once abandoning the state of Maine," said Dr. Vivek Gore, senior vice president, CNSI. "Today's announcement is the culmination of our customer-centric focus and integrity toward issue management, ability to address problems and mitigate them in a timely fashion, and superior operations and system performance lending to greater stabilization of processing cycles and increased system throughput. We remain committed to DHHS and the citizens of Maine."

MECMS is the industry's first J2EE, Web-centric MMIS. MECMS is a standards-based system that's aligned with CMS' Medicaid Information Technology Architecture (MITA) framework and supports service-oriented architecture (SOA). The system handles claims using automated processes, thereby minimizing the amount of manual intervention by state staff and ensuring more timely payments. Other benefits of MECMS as compared to Maine's legacy MMIS include:

--  A rules engine-based claims adjudication to facilitate the rapid
    implementation of changes to business rules and edits
--  A browser-based system for increased access by all stakeholders
--  Provider relations management supplying online information about
    payments, remittances and eligibility data
--  Work flow management for adjudicating suspended claims per policy
    timelines
--  Incorporation of new policy changes online making them available for
    immediate implementation and use
--  Real-time access to reference data, claim information and eligibility
    status via the Web
    

CNSI's next-generation MMIS solution, eCAMS®, is based on the MECMS platform and continues to evolve and mature with new features and functionality. CNSI is currently implementing this solution for the states of Michigan, South Dakota and Washington.

ABOUT CNSI

CNSI is a full-service IT business solutions provider that has enjoyed steady growth since its incorporation in 1994. Headquartered in Rockville, Maryland with offices throughout the U.S., CNSI delivers a broad portfolio of IT and business process outsourcing solutions to a diverse base of commercial and government clients, including Department of Homeland Security, Federal Aviation Administration, Department of Energy, Amtrak, and several state agencies. For more information, please visit www.cns-inc.com.

Contact Information