The Iowa Medicaid Enterprise (IME) administers the State’s Medicaid program for over 560,000 Iowans. IME is transitioning from a traditional Fee-For-Service (FFS) claims payment model to a Managed Care Organization (MCO) reimbursement model. To better serve the members of its community, IME has contracted with several professional and systems services providers to support the operations of the Medicaid program.
Planning and Procurement Support
IME selected CSG to develop a holistic approach to help the State define and build a foundation for its Medicaid enterprise and affiliated professional and system services that aligns with the operational needs of the new MCO model. We provided research and planning support to help IME navigate the changing Medicaid landscape and obtain enhanced federal funding in accordance with MITA and the new CMS guidance for certification criteria and modular system standards. CSG also defined RFP-ready requirements that are mapped to CMS’ requirements checklist, developed RFPs and Advance Planning Documents (APDs), and assisted in the evaluation of bids and contract negotiations to procure qualified vendors to support IME operations moving forward.
