Sole Source Justification Form

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

Sole Source Justification Form - Part I Section I - General Information

Department/Bureau/Section: Healthcare and Family Services, Medical Programs

Need Identified Date: Aug 7, 2025 Supply/Service Need By Date: Apr 1, 2026

Project Title: Advanced Communication Engine (ACE)

Vendor: Optum Government Solutions, Inc.

Provide a description of the supplies or services required:

The Agency seeks to enter into a one (1) year sole source contract with Optum Government Solutions to continue to meet the legislative mandate 305 ILCS 5/5-30.12 which is a technical solution to assist both the Managed Care Organizations (MCOs) and the providers in reducing claim billing errors and reduce the number of MCO denials. Optum Government Solutions will provide Advanced Communication Engine (ACE) Solution Maintenance and Support Services, iEDI Software Support Services, Informatica B2B Software Subscription, Informatica Power Center Software Subscription, SOC Reporting, and professional services for the Enterprise Data Warehouse (EDW) interfaces and the ACE EDW Analytics.

Value: Estimated Value of Initial Term, this Change Order or Amendment: 7,472,214

Will this Sole Source amend a Professional or Artistic Services contract? Yes No

*Sole Source may not be used for amendments for Professional or Artistic Services if the amendment would increase the value by more than 5% of the initial award or extend the term by more than 60 days.

Type: New Sole Source

Section II - Proposed Term

One-Time Purchase Term Contract

Estimated Contract Begin Date: Apr 1, 2026

Estimated Contract End Date: Mar 31, 2027

Number of Potential Renewals:

Length of Each Renewal in Months:

Total Value of All Renewals:

If a Term Contract, does the term, including renewals, exceed 12 months? Yes No

Section III - Funding Source Select the type of funding to be used (Check all that apply): State Appropriate Funds Federal Funds Other (Explain):

Section IV - Sole Source Justification

This purchase is economically only available from a single source primarily because it is: (If "Other" explain in one sentence)

Software License/Upgrade/Maintenance

Are there secondary justification(s) for this sole source? Yes No

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

Section V - Purchase History

Has the Agency or University Purchased these supplies or services in the past? Yes No

Term Term From Term To Value Description Contract Number Type

1 Sep 30, 2019 Mar 31, 2023 45,837,916 Advance Communication Engine ("ACE") 2020-21-001 Sole Source

2 Apr 1, 2023 Mar 31, 2024 6,832,800 Advance Communication Engine ("ACE") 2023-36-003 Sole Source

3 Apr 1, 2024 Mar 31, 2025 7,029,154 Advance Communication Engine ("ACE") 2024-26-001 Sole Source

4 Apr 1, 2025 Mar 31, 2026 7,244,329 Advance Communication Engine ("ACE") 2025-36-001 Sole Source

If more than 10, or if other comments, explain:

Section VI - Business Rationale

1. Provide a detailed explanation of the need for the supplies or services:

The Agency seeks to enter into a one (1) year sole source contract with Optum Government Solutions to continue fulfilling the legislative mandate 305 ILCS 5/5-30.12. This mandate requires the implementation and maintenance of a technical solution that supports both the MCOs and providers in reducing claim billing errors and minimizing the number of MCO denials.

Under this mandate, claims submitted by providers using either the X12 837i or an 837p format are sent to Optum’s iEDI system.

Simultaneously, a copy of each claim is transmitted to the Agency’s Enterprise Data Warehouse (EDW), while the claims are sent to the MCO’s clearinghouse. The MCO responses to the claim billings both the X12 277CA (claim is rejected or accepted) and the X12 835 (claim is denied or paid) are also sent to the EDW at the same time that the files are sent to the provider.

The EDW ACE team performs detailed analysis from the EDW on these claims to determine the reasons for rejections and denials, measuring frequency, and gathering other relevant data points to better understand and address systemic billing issues. The Agency also licensed Optum’s ACE software to provide more robust edit descriptions to give the providers more information to correct billing errors.

Using the data sent from the iEDI, the Agency has developed a series of interactive analytic dashboards using Tableau that provide both a summary and detail level view of both the MCO rejects/denials and reasons. The series of dashboards slice the data in various ways by provider, provider type and MCO. Based on Agency approval and request, Optum will assist the Agency with publishing the dashboards for stakeholder access and supporting user inquires. The goal is to assist both the provider and the MCOs to identify and reduce the number of payment billing errors to streamline the billing process. The Agency is also using more robust edit responses from ACE to compare to the MCO edit responses. This will assist the provider in correcting payment billings errors quickly without multiple submissions of the claim delaying provider payment for services.

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

2. Provide a list and describe in detail the specifications required to satisfy the need:

The Agency requires ongoing maintenance and operations support for the ACE system. The vendor must provide comprehensive operations and maintenance services that includes all activities necessary to ensure the continued functionality, performance and compliance of the system. At a minimum, the vendor will be responsible for the following:

ACE Solution Maintenance and Support Services: Optum will provide the Application Management Services and Software Support Services for the ACE Software, and other Vendor Supplied COTS Software (Informatica). Optum shall supply the staff to manage the iEDI/ACE Enterprise Data Warehouse (EDW) project, Extract, Transfer and Load (“ETL”) interfaces tasks, and Business Intelligence (BI) reporting/analytics tasks related maintenance and operations services. As part of the Maintenance and Support Services, Optum will also provide updated National and Illinois State Medicaid data files, CPT/ICD10 content and system software updates to capabilities and technology at the frequency they are published and/or update.

iEDI Software Support Services: Optum will provide and maintain general support for the iEDI Gateway solution and will use reasonable efforts to resolve any questions and issues reported to Vendor Support via the Agency portal on a 24 hours a day, 7 days a week basis, excluding scheduled maintenance periods.

Annual Informatica B2B Software Subscription and an annual Informatica Power Center Software Subscription to enhance the intake process allowing for more volume of data files and process request 24 hours a day, 7 days a week, if needed, excluding scheduled maintenance periods. This will increase the file volume intake.

Provide SOC 2 Type 1 within 120 days of contract execution including a certification ensuring that the controls will remain the same for the duration of the contract.

Professional Services to provide support for EDW interfaces maintenance and operations, ACE EDW Analytics, a Business Intelligence resource dedicated to developing and delivering the reporting and analytics as part of the ACE Solution Maintenance and Support services, and EDW Specialist Support to provide the necessary subject matter expertise on varying aspects of the ACE project.

Provide Transition and Decommissioning Activities - If directed by HFS, the Vendor shall decommission the ACE solution, including data extraction, retention, and system shutdown activities.

3. Provide detail explaining the justification selected in Section IV to explain why the requested supplies or services are the only ones available that can satisfy the agency or university requirements?

Optum is currently the only vendor with a fully deployed and operationalized solution that is integrated with the State’s Enterprise Data Warehouse, provider billing workflows, and MCO routing processes. The Agency is committed to ensuring long-term cost effectiveness and will use the period of the one-year sole course to evaluate the market and consider competitive procurement strategies for future years. This Sole Source contract is limited to maintaining continuity and compliance during the current period while the Agency assesses longer-term procurement options.

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

4. What are the unique features of the supplies or services that are not available in any other product or by any other vendor? Provide specific quantifiable factors/qualifications:

Optum ACE is currently the only solution implemented and operational for HFS that satisfies these statutory requirements in an integrated, production-ready environment without material modification, redevelopment, or transition risk.

Specifically, Optum ACE provides the following capabilities in an operational HFS-integrated solution:

• Pre-adjudication claim edits configured to Illinois-specific statutory and program requirements, rather than generic vendor-standard edit logic.

• Provider-facing explanatory claim response language that is configurable by the State and aligned to Illinois statute, enabling providers to understand rejection or denial reasons and take corrective action.

• Automated capture and retention of claim and response data within the Department’s Enterprise Data Warehouse (EDW) to support audit, reporting, transparency, and compliance monitoring.

• Demonstrated operational performance at HFS scale, supporting current claim volumes and business processes without disruption to services.

Transitioning to an alternative solution that is not currently implemented for HFS would require substantial configuration, integration, testing, and validation, creating a material risk of disruption to claims processing and provider reimbursement. Maintaining uninterrupted claims operations is critical to ensuring timely provider payment and continued access to services for HFS program participants.

5. Has the Agency or University considered alternative supplies or services to satisfy their need? Yes No

5a. If yes, name the alternative vendors whose supplies or services were evaluated:

During market research, the Agency considered the following vendors as potential alternatives for the required services:

Availity Acentra Health

These vendors were identified as offering claims-related or connectivity services with partial or adjacent functionality relevant to the Agency’s needs. Market research included review of existing HFS implementations, prior procurements, available cooperative contracts, and publicly available vendor information.

5b. If yes, what were the alternatives for each vendor and why were they unacceptable? Be specific with regard to features, characteristics, requirements, capabilities and compatibility:

The Agency determined that none of the identified alternatives currently provide an operational, HFS-integrated solution capable of meeting Illinois-specific statutory, operational, and compliance requirements without material modification.

Availity provides claims connectivity services but does not support the full range of Illinois-specific pre-adjudication edit messaging required for this work. In addition, Availity does not provide functionality to transmit X12 transactions to the Department’s EDW or to perform the analytics necessary to support statutory transparency, reporting, and compliance monitoring.

Acentra Health’s iEDI gateway is not currently configured or operationalized to perform the specific functional requirements associated with this work. Implementing those capabilities would require additional planning, development, configuration, integration, and testing prior to use in a production environment.

5c. Explain how the market evaluation was conducted?

*This evaluation is to determine available options within a market. If the evaluation is to determine quality or best suited option, this is not the appropriate source selection. Under no circumstances shall the evaluation consist of testing alternative options. These activities must be conducted in a competitive transparent environment (i.e. IFB or RFP).

In conducting market research, the Agency reviewed publicly available information and prior procurements related to Availity, and Acentra Health. That review did not identify an alternative solution that is currently operational for HFS and capable of providing Illinois-specific pre-adjudication edit messaging, payor-defined flexibility to support provider correction, transmission of X12 transactions to the Department’s Enterprise Data Warehouse, and associated analytics required by statute, without material configuration or redevelopment.

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

6. Are there resellers or distributors?

Yes No N/A

7. What efforts were made to get the best possible price (i.e. did the agency/university negotiate) and how did you determine the price for this purchase is considered fair and reasonable?

The Agency already owns the ACE license. Since the Agency contracts with Optum to manage and maintain the EDW, the agency negotiated the price which significantly reduced the cost of the continued ACE maintenance and operations and analytic solution.

The cost for a one-year sole source contract with Optum Government Solutions is broken down into the the following services and prices:

Annual Advanced Communication Engine (ACE) Solution Maintenance and Support Services: $4,769,099 Annual iEDI Software Support Services: $180,845 Informatica B2B Software Subscription: $193,000 Informatica Power Center Software Subscription: $240,520 SOC Reporting: $106,090 Professional services for the EDW interfaces and the ACE EDW Analytics: $1,968,570 Transition and Decommissioning Activities: $14,090 Total: $7,472,214.00

This price is considered fair and reasonable because the Agency avoids the substantial implementation, system redevelopment, provider and MCO on-boarding, data migration, and re-validation costs that would be required if a new vendor were procured to replace the existing solution. Maintaining the current integrated ACE/iEDI/EDW environment prevents service disruption, ensures continuity of claims processing, protects compliance with statutory requirements, and avoids additional expenditures that would otherwise be borne by the State, providers, and MCOs.

8. Will this purchase obligate the State to this vendor for future purchases such as maintenance, licensing or continuing need?

Yes No

9. What will be the financial or other impact to the State if this sole source is not approved and a competitive bid is required?

The non-financial impact of this sole source not being approved is that the contract is necessary to continue HFS’ compliance with 305 ILCS 5/5-30.12 “Managed care claim rejection and denial management”. As noted in 5a above no other Vendor has the software necessary to fulfill the requirements of the statute. The Providers, MCOs and the Agency have spent a significant amount of time, money and effort in routing these claims through Optum’s iEDI and back to the Department’s EDW. To undo this routing of claims would create a significant burden and cost on both the providers and the MCOs.

The ACE solution has provided transparency into the provider billing MCO adjudication highway. The Agency now has the data it needs not only meet the legislative objective to report this information, but also to assist the providers and MCOs in reducing the number of unnecessary rejections and denials.

10. Is there any additional information you would like to add to justify this sole source?

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

Section VII

Requesting Department Representative

Requesting Department Signature Required

I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed.

Date Feb 24, 2026

Printed Name Helena Lefkow E-mail Address helena.c.lefkow@illinois.gov

Phone Number 312-636-7696

State Agency Bureau/Division Head or University Purchasing Director Approval and Signature Required

I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed. (All prior form fields will lock once this e-signature is completed)

E-mail Address Monique.N.Wantland@illinois.gov

Phone Number 217-557-5777 Date Feb 24, 2026

Printed Name Monique Wantland

Agency Bureau/Division Head or University Purchasing Director and Not a Designee

SPO Approval and Signature Required

I have reviewed and understand the contents of this Sole Source Justification and agree with the State Agency or University determination.

I have reviewed and understand the contents of this Sole Source Justification and do not agree with the State Agency or University determination. As a result, the State Agency or University must explore other sourcing methods to satisfy their need.

State Purchasing Officer Signature Phone Number 217-993-1719 Date Feb 24, 2026

Printed Name Jennifer Klein E-mail Address jennifer.klein@illinois.gov

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Bulletin Reference Number 26-478HFS-DIREC-B-51260

Requesting Agency/University Department of Healthcare and Family Services

Sole Source Justification Form - Part II Section I - General Information

Project Title Advanced Communication Engine (ACE)

Vendor Optum Government Solutions, Inc.

Initial Date of Procurement Bulletin Posting Feb 25, 2026

Was a Sole Source hearing held per 30 ILCS 500/20-25?

Yes - Complete Section II and III below (Section II will only be visible when this option is selected)

No - Section II not required, go to Section III below Section III - CPO Approval and Signature Required

Based on my review, I authorize the Agency/University to proceed in accordance with the published Notice referenced above.

Based upon my review, I authorize the Agency/University to proceed with the following Changes.

Based on my review, the Agency/University is not authorized to proceed with this sole source as presented and my recommendation is that it be cancelled.

Other

CPO Signature CPO Phone 217-622-1857

Printed Name Ellen H. Daley Date

CPO E-mail ellen.h.daley@illinois.gov

Version 7.01 Page of Sole Source Justification Form - Part I Section I - General Information Will this Sole Source amend a Professional or Artistic Services contract?

If yes, what was the original contract value?

*Sole Source may not be used for amendments for Professional or Artistic Services if the amendment would increase the value by more than 5% of the initial award or extend the term by more than 60 days.

Section II - Proposed Term If a Term Contract, does the term, including renewals, exceed 12 months?

If yes, provide a detailed justification including any economic benefit received for agreeing to a multi-year term:

Section III - Funding Source Select the type of funding to be used (Check all that apply):

Section IV - Sole Source Justification Are there secondary justification(s) for this sole source?

Section V - Purchase History Has the Agency or University Purchased these supplies or services in the past?

Term Term From Term To Value Description Contract Number Type Section VI - Business Rationale

1. Provide a detailed explanation of the need for the supplies or services:

2. Provide a list and describe in detail the specifications required to satisfy the need:

3. Provide detail explaining the justification selected in Section IV to explain why the requested supplies or services are the only ones available that can satisfy the agency or university requirements?

4. What are the unique features of the supplies or services that are not available in any other product or by any other vendor? Provide specific quantifiable factors/qualifications:

5. Has the Agency or University considered alternative supplies or services to satisfy their need?

5a. If yes, name the alternative vendors whose supplies or services were evaluated:

5b. If yes, what were the alternatives for each vendor and why were they unacceptable? Be specific with regard to features, characteristics, requirements, capabilities and compatibility:

5c. Explain how the market evaluation was conducted?

*This evaluation is to determine available options within a market. If the evaluation is to determine quality or best suited option, this is not the appropriate source selection. Under no circumstances shall the evaluation consist of testing alternative options. These activities must be conducted in a competitive transparent environment (i.e. IFB or RFP).

5a. If no, why weren't alternatives evaluated?

6. Are there resellers or distributors?

7. What efforts were made to get the best possible price (i.e. did the agency/university negotiate) and how did you determine the price for this purchase is considered fair and reasonable?

8. Will this purchase obligate the State to this vendor for future purchases such as maintenance, licensing or continuing need?

8a. If yes, please provide details regarding future obligations and/or needs:

9. What will be the financial or other impact to the State if this sole source is not approved and a competitive bid is required?

10. Is there any additional information you would like to add to justify this sole source?

Section VII Requesting Department Signature Required I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed.

State Agency Bureau/Division Head or University Purchasing Director Approval and Signature Required I know and understand the contents of this Sole Source Justification and attest that all statements are true and correct and the fairness and reasonableness of the price was adequately confirmed. (All prior form fields will lock once this e-signature is completed) SPO Approval and Signature Required Sole Source Justification Form - Part II Section I - General Information Was a Sole Source hearing held per 30 ILCS 500/20-25?

Section II - Sole Source Hearing Details The State posted to the Illinois Procurement Bulletin a description of the State's need, the justification for the sole source decision, and information regarding the opportunity to submit comments and testify at a public hearing. Notice of the hearing was also posted outside of the hearing room 48 hours prior to the hearing.

The public hearing was conducted for the purpose of receiving testimony regarding the sole source determination. The Hearing Officer recommends the following:

The following relevant documents are attached:

Section III - CPO Approval and Signature Required 9.0.0.2.20101008.1.734229 ellen.h.daley@illinois.gov

Under this mandate, claims submitted by providers using either the X12 837i or an 837p format are sent to Optum’s iEDI system. Simultaneously, a copy of each claim is transmitted to the Agency’s Enterprise Data Warehouse (EDW), while the claims are sent to the MCO’s clearinghouse. The MCO responses to the claim billings both the X12 277CA (claim is rejected or accepted) and the X12 835 (claim is denied or paid) are also sent to the EDW at the same time that the files are sent to the provider.

The EDW ACE team performs detailed analysis from the EDW on these claims to determine the reasons for rejections and denials, measuring frequency, and gathering other relevant data points to better understand and address systemic billing issues. The Agency also licensed Optum’s ACE software to provide more robust edit descriptions to give the providers more information to correct billing errors.

Using the data sent from the iEDI, the Agency has developed a series of interactive analytic dashboards using Tableau that provide both a summary and detail level view of both the MCO rejects/denials and reasons. The series of dashboards slice the data in various ways by provider, provider type and MCO. Based on Agency approval and request, Optum will assist the Agency with publishing the dashboards for stakeholder access and supporting user inquires. The goal is to assist both the provider and the MCOs to identify and reduce the number of payment billing errors to streamline the billing process. The Agency is also using more robust edit responses from ACE to compare to the MCO edit responses. This will assist the provider in correcting payment billings errors quickly without multiple submissions of the claim delaying provider payment for services.

Q2Answer: The Agency requires ongoing maintenance and operations support for the ACE system. The vendor must provide comprehensive operations and maintenance services that includes all activities necessary to ensure the continued functionality, performance and compliance of the system. At a minimum, the vendor will be responsible for the following:

ACE Solution Maintenance and Support Services: Optum will provide the Application Management Services and Software Support Services for the ACE Software, and other Vendor Supplied COTS Software (Informatica). Optum shall supply the staff to manage the iEDI/ACE Enterprise Data Warehouse (EDW) project, Extract, Transfer and Load (“ETL”) interfaces tasks, and Business Intelligence (BI) reporting/analytics tasks related maintenance and operations services. As part of the Maintenance and Support Services, Optum will also provide updated National and Illinois State Medicaid data files, CPT/ICD10 content and system software updates to capabilities and technology at the frequency they are published and/or update.

iEDI Software Support Services: Optum will provide and maintain general support for the iEDI Gateway solution and will use reasonable efforts to resolve any questions and issues reported to Vendor Support via the Agency portal on a 24 hours a day, 7 days a week basis, excluding scheduled maintenance periods.

Annual Informatica B2B Software Subscription and an annual Informatica Power Center Software Subscription to enhance the intake process allowing for more volume of data files and process request 24 hours a day, 7 days a week, if needed, excluding scheduled maintenance periods. This will increase the file volume intake.

Provide SOC 2 Type 1 within 120 days of contract execution including a certification ensuring that the controls will remain the same for the duration of the contract.

Professional Services to provide support for EDW interfaces maintenance and operations, ACE EDW Analytics, a Business Intelligence resource dedicated to developing and delivering the reporting and analytics as part of the ACE Solution Maintenance and Support services, and EDW Specialist Support to provide the necessary subject matter expertise on varying aspects of the ACE project.

Provide Transition and Decommissioning Activities - If directed by HFS, the Vendor shall decommission the ACE solution, including data extraction, retention, and system shutdown activities.

Specifically, Optum ACE provides the following capabilities in an operational HFS-integrated solution:

• Pre-adjudication claim edits configured to Illinois-specific statutory and program requirements, rather than generic vendor-standard edit logic.

• Provider-facing explanatory claim response language that is configurable by the State and aligned to Illinois statute, enabling providers to understand rejection or denial reasons and take corrective action.

• Automated capture and retention of claim and response data within the Department’s Enterprise Data Warehouse (EDW) to support audit, reporting, transparency, and compliance monitoring.

• Demonstrated operational performance at HFS scale, supporting current claim volumes and business processes without disruption to services.

Transitioning to an alternative solution that is not currently implemented for HFS would require substantial configuration, integration, testing, and validation, creating a material risk of disruption to claims processing and provider reimbursement. Maintaining uninterrupted claims operations is critical to ensuring timely provider payment and continued access to services for HFS program participants.

Availity Acentra Health

These vendors were identified as offering claims-related or connectivity services with partial or adjacent functionality relevant to the Agency’s needs. Market research included review of existing HFS implementations, prior procurements, available cooperative contracts, and publicly available vendor information.

Q5bAnswer: The Agency determined that none of the identified alternatives currently provide an operational, HFS-integrated solution capable of meeting Illinois-specific statutory, operational, and compliance requirements without material modification.

Availity provides claims connectivity services but does not support the full range of Illinois-specific pre-adjudication edit messaging required for this work. In addition, Availity does not provide functionality to transmit X12 transactions to the Department’s EDW or to perform the analytics necessary to support statutory transparency, reporting, and compliance monitoring.

Acentra Health’s iEDI gateway is not currently configured or operationalized to perform the specific functional requirements associated with this work. Implementing those capabilities would require additional planning, development, configuration, integration, and testing prior to use in a production environment.

The cost for a one-year sole source contract with Optum Government Solutions is broken down into the the following services and prices:

Annual Advanced Communication Engine (ACE) Solution Maintenance and Support Services: $4,769,099 Annual iEDI Software Support Services: $180,845 Informatica B2B Software Subscription: $193,000 Informatica Power Center Software Subscription: $240,520 SOC Reporting: $106,090 Professional services for the EDW interfaces and the ACE EDW Analytics: $1,968,570 Transition and Decommissioning Activities: $14,090 Total: $7,472,214.00

This price is considered fair and reasonable because the Agency avoids the substantial implementation, system redevelopment, provider and MCO on-boarding, data migration, and re-validation costs that would be required if a new vendor were procured to replace the existing solution. Maintaining the current integrated ACE/iEDI/EDW environment prevents service disruption, ensures continuity of claims processing, protects compliance with statutory requirements, and avoids additional expenditures that would otherwise be borne by the State, providers, and MCOs.

ILCS 5/5-30.12 “Managed care claim rejection and denial management”. As noted in 5a above no other Vendor has the software necessary to fulfill the requirements of the statute. The Providers, MCOs and the Agency have spent a significant amount of time, money and effort in routing these claims through Optum’s iEDI and back to the Department’s EDW. To undo this routing of claims would create a significant burden and cost on both the providers and the MCOs.

The ACE solution has provided transparency into the provider billing MCO adjudication highway. The Agency now has the data it needs not only meet the legislative objective to report this information, but also to assist the providers and MCOs in reducing the number of unnecessary rejections and denials.