Decision Support System

The vendor is required to provide decision support system (DSS), data warehouse (DW), and analytical support, collectively referred to as the “DSS solution” or “solution.”
- The solution must support the program and the day-to-day operations of the Medicaid business units.
- The DSS solution must fully replace the following:
•    program existing functionality for the decision support system (DSS)
•    Data warehouse (DW)
•    Surveillance utilization review subsystem (SURS), also known as program integrity (pi)
•    Fraud abuse detection system (fads)
•    Management administrative reporting subsystem (mars)
•    Transformed Medicaid statistical information system (T-MSIS) to include T-MSIS early warning dashboards
•    Payment error rate measurement (perm)
•    Any department and federal reporting
- Requirement
•    Includes the design, development, and implementation (DDI) of the DSS solution that provides direct data access, as well as predefined reporting and visualizations to support the full breadth of stakeholder types that engage with the DSS. 
•    The DSS solution must fully replace the state program existing functionality for the decision support system (DSS), data warehouse (DW), surveillance utilization review subsystem (SURS)---also known as program integrity (PI), fraud abuse detection system (FADS), management administrative reporting subsystem (MARS), transformed Medicaid statistical information system (T-MSIS) to include T-MSIS early warning dashboards, payment error rate measurement (perm), any additional department, state and federal reporting, and reporting produced from the integrated eligibility system as directed by department. 
•    The reporting spans the ability to evaluate the healthcare program quality and financial impacts, as well as addressing formal Medicaid state and federal reporting of mars, SURS, fads, and generation of transformed Medicaid statistical information system (T-MSIS) files for the centers for medicare and Medicaid services (CMS). 
•    Includes the operational services required to maintain the DSS, enhancement projects, create reports, and provide support and training to the user community. 
•    Provide the necessary functions, system capabilities, and user features to support department in efficiently delivering and promoting better data management and analytics. 
•    This includes the ability to address data analytics requirements, including but not limited to core set reporting, quality metrics reporting and analysis, and ad hoc research projects. 
•    The contractor’s system must maintain interfaces with systems internal and external to the program system that are necessary for the DSS to deliver services to department. 
•    The contractor shall propose a DSS that:
o    As the ability to change and respond to changes in the health care industry 
o    Has a verifiable record of accomplishment of successful implementations within a defined time 
o    Has business plans that demonstrate a corporate commitment to product enhancement with routine releases 
o    Comprised of systems and processes that learn and adapt to new challenges and provide utilities or services that integrate with health care on an enterprise-wide level.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: September 15, 2025