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FOX's extensive research and vast knowledge base makes
it unique, and supports our ability to provide the most
insightful view of today’s Medicaid administrative
marketplace. FOX has also developed a strong practice in
working with other publicly funded healthcare
organizations including Medicaid managed care
organizations, public and behavioral health
organizations, and Medicaid-focused providers. Having
worked with numerous Medicaid agencies in product
definition, market strategy development, and strategic
planning, FOX is a leader in establishing the role of
the private sector in Medicaid administration. We also
hold chairs in the Private Sector Technology Group that
represents the community of Medicaid vendors and
consults with Centers for Medicare & Medicaid Services
(CMS).
FOX earned its Medicaid reputation by working with over
35 states to provide system definition, system
development, requirements analysis, procurement support,
strategic planning, Independent Verification and
Validation (IV&V), Y2K assessment, and HIPAA assessment
and remediation services.
At the federal level, FOX has worked with the Centers
for Medicare & Medicaid Services (CMS) on several key
Medicaid systems initiatives:
- Key subcontractor
in the assessment and audit of state Y2K and HIPAA
remediation efforts
- Key subcontractor
in providing support to states for HIPAA
- Development of
strategy and the Medicaid HIPAA Compliant Concept
Model (MHCCM) for Medicaid enterprises
- Key subcontractor
in defining the Medicaid Information Technology
Architecture (MITA) for the 21st century
The following
statements highlight FOX Medicaid/MMIS experience that
demonstrates the depth of its expertise and experience:
- 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
clients
- 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
- Prepared a cost
allocation model and associated memorandum of
understanding (1996) between New Mexico’s Medicaid
and Public Health agencies to provide enhanced
federal funding in Medicaid-supportive systems in
the public health agency
- Produced the first
Service Level Agreement (SLA) model for Fiscal
Agency performance standards (Florida 1992)
- Developed the
first Per Member Per Month (PMPM) Fiscal Agent
reimbursement model for capitated managed care
operations (Virginia 1994)
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