Florida Medicaid Management Information System Takeover and Modernization

The Florida Agency for Health Care Administration (AHCA) has issued a Request for Information (RFI) for the Florida Medicaid Management Information System (FMMIS) Takeover and Modernization project, focusing on transitioning and modernizing the existing Medicaid management system. This RFI, posted on April 1, 2025, with responses due by May 1, 2025, seeks industry input on creating a standalone module with fundamental Medicaid processing functionality, including claims adjudication, encounter processing, and financial management. The project is part of the Florida Health Care Connections (FX) transformation, which aims to modernize Medicaid technology using a modular approach. The RFI specifically targets vendors who can provide recommendations on modular transition, operations and maintenance, and modernization of the legacy system. Attachment A to the RFI provides a comprehensive list of 22 modernization and 19 modularization items, ranging from improving EDI offerings to integrating with enterprise tools. Vendors who submit responses may be invited to present their ideas directly to Agency leadership, with the current FMMIS operations and maintenance contract set to expire on December 31, 2027.

The current FMMIS is operated by Gainwell Technologies, LLC, and the Agency is seeking innovative solutions for system modernization. While no specific set-aside designations or restrictions on respondent types are explicitly mentioned, the RFI suggests a comprehensive approach to system transformation that may require significant technical expertise and experience in healthcare information systems. The Agency has already implemented base technology for individual modules and is working on consolidating operations into a Unified Operations Center. Although no specific budget range is provided, the complexity of the project implies a substantial investment in modernizing the Medicaid Management Information System. The RFI is structured as a planning tool under Section 287.012(22) of Florida Statutes, emphasizing that no contract award will directly result from this information-gathering process. Potential respondents should be prepared to demonstrate capabilities in modular system design, healthcare technology integration, and comprehensive Medicaid processing solutions.