Florida Medicaid Management Information System Takeover and Modernization

Agency for Health Care Administration

Buyer is seeking information regarding the takeover and modernization of the Florida Medicaid Management Information System (FMMIS) and associated Fiscal Agent business processes. The system will adjudicate Fee-for-Service claims, process managed care encounters, support financial activities, and maintain recipient eligibility. Buyer is requesting innovative ideas, best practices, and proven experience in transitioning and modernizing legacy MMIS systems within a modular environment. The current contract for operations and maintenance expires on December 31, 2027.

• 4/1/2025 - RFI Release
• 4/8/2025 - Questions Due
• 4/17/2025 - Anticipated Answers to Questions Posted
• 5/1/2025 - Proposal Due Date

• Transition existing FMMIS system operations without degradation in services
• Adjudicate Fee-for-Service claims for Medicaid reimbursement in real-time
• Process managed care encounter claims with enhanced validation
• Support diverse reimbursement methodologies for FFS and managed care
• Generate capitation payments to health plans based on recipient assignments
• Implement configurable business rules engine replacing embedded code
• Modernize EDI offering with SNIP Level 4 to 7 compliance
• Migrate platform and hosting to cloud infrastructure
• Integrate with ForgeRock SSO and sunset legacy MEUPS
• Implement disaster recovery processes aligned with FX Enterprise standards