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Fiscal Agent Procurement Support Services

FOX Systems, Inc. (FOX) offers a unique blend of Medicaid Management Information System (MMIS) and Fiscal Agent Procurement Support Services. Our contract and procurement expertise and experience is second to none.

Government Consulting

 

In addition, we are one of the nation’s premier Health Insurance Portability and Accountability Act (HIPAA) consultants and we understand the impacts of the HIPAA legislation on state Medicaid agencies. FOX has a reputation for excellence, and we are confident that our team can successfully achieve the goals of any Fiscal Agent procurement process. For information on non-MMIS Procurement Support Services, please read about our Procurement and Documentation Services at the following page: Procurement & Documentation Services

FOX has performed Managed Medicaid Fiscal Agent / MMIS procurement projects for several states including Alaska (twice), Arkansas, Florida (twice), Georgia, Illinois, Iowa, Louisiana, New Mexico, Virginia, Tennessee, and Oregon. These projects have included various levels of Fiscal Agent Procurement Support Services including current state analysis, MMIS requirements analysis, RFI development, APD and RFP development, Fiscal Agent performance standard development, bidder’s conference and evaluation support, and Independent Verification and Validation (IV&V) services.

Highlights for specific projects include:

  • Selected by both Florida and Alaska twice in a row to manage its procurement for takeover of Fiscal Agent services
  • Developed new contractor payment strategies for procurements in Tennessee, Virginia, Alaska, Georgia, and Arkansas
  • Developed widely different evaluation methodologies to suit the specific needs of Tennessee, Florida, Virginia, New Mexico, and Georgia as well as for our non-Medicaid client needs
  • Developed contractor performance measures for Arkansas and designed the performance-based reimbursement plan, a first in the country, for Arizona’s innovative welfare privatization pilot program
  • Surveyed other state MMIS systems and Fiscal Agent contracting processes for Oregon, Tennessee, Virginia, Florida, and Alaska to collect best practices in contract administration and Medicaid system technology
FOX has also managed other large healthcare system procurements including public health and mental health (Los Angeles County, California), managed care (Maricopa County, Arizona), behavioral health (Orange County, California and State of New Mexico), and national dental claims processing (National Delta Dental).

FOX and its consultants possess the most relevant Medicaid, MMIS, and HIPAA experience in the industry.

We have provided services to Centers for Medicare & Medicaid Services (CMS) on three important projects:

  • Y2K Independent Verification and Validation (IV&V) support,
  • Surveillance and Utilization Review System (SURS) Best Practices, and
  • Development of the Medicaid HIPAA Compliant Concept Model (MHCCM).
FOX served as the key contractor on the MHCCM project and Dr. Susan Fox (Chair of the FOX Board of Directors) served as the Technical Manager for the MHCCM project. Through our technical assistance work to states during our Y2K and MHCCM projects, FOX has visited most Medicaid Programs and has had a unique opportunity to identify and observe best practices with respect to MMIS Fiscal Agent procurements, implementations, and operations across the country.

In addition to MHCCM, FOX is presently providing analytical / technical support and information collection / analysis for the Medicaid Information Technology Architecture (MITA) project. The goal of this project is to produce a clearly documented conceptual Medicaid information technology architecture based on industry best practices, current MMIS reform efforts, technology trends, and other sources.

FOX's roles in the MHCCM and MITA projects give FOX an unsurpassed familiarity with current and anticipated CMS requirements that impact Medicaid and MMIS Fiscal Agent operations. We believe that our in-depth understanding of the issues germane to MMIS procurements and the applicability of the HIPAA regulations to the Medicaid program differentiate the FOX Team from our competitors.

 

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