Medicaid Enterprise Systems - Claims Processing and Management Services Module
Buying from a NASPO ValuePoint Contract? Learn How
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How to Buy from a NASPO ValuePoint Contract
If you’ve identified a portfolio or supplier on the NASPO ValuePoint website and are ready to make a purchase:
The first step is to check whether your state has a Participating Addendum (PA) for that contract. Each PA outlines which entities within the state (such as agencies, counties, cities, public universities, or school districts) are authorized to purchase from the agreement.
If your organization is covered by a PA:
The next step is to follow your state’s or your organization’s established procurement procedures to complete the purchase. NASPO ValuePoint does not issue purchase orders or manage individual transactions, as each state or local entity retains its own procurement authority. These processes can vary widely, some state agencies may be required to use a central procurement platform (for example, an ERP (SAP, Workday, JD Edwards, etc.) or eProcurement System (Ivalua, SOVRA, CGI Advantage, etc.)), while local entities such as public universities or municipalities may have their own systems and approval thresholds.
Because these rules differ from state to state and even between organizations within the same state, NASPO ValuePoint cannot prescribe a single buying process, but encourages purchasers to work within their local procurement guidelines when utilizing NASPO ValuePoint contracts.
Portfolio Snapshot
Everything you need to know about this portfolio's solicitation process.
Solicitation Documents
About the Portfolio
A Medicaid Management Information System (also known as MMIS) is a mechanized claims processing and information retrieval system that all states are required to have according to section 1903(a)(3) of the Social Security Act defined in Federal Code 42 CFR 433.111. The NASPO ValuePoint MMIS Claims Processing and Management Services Module portfolio supports the receipt, adjudication and editing, pricing and payment for State Medicaid healthcare program claims. Below are a few of the benefits from the Master Agreements within this portfolio:
- Availability of Medicaid healthcare claims processing systems and operational services to support the requirements of healthcare programs administered by a State Medicaid agency.
- Qualified suppliers that can provide modern, flexible, and configurable solutions that will support the changing needs of healthcare for State Medicaid agencies.
- Delivered using a Software as a Service (SaaS).
Products & Services
- Core Service SaaS Solution
- Option A - Financial Management and Financial Reporting
- Option B - Call Center (Member and Provider Call Center)
- Option C - Federal Reporting
Have suggestions for additional products and services in this portfolio?
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NASPO ValuePoint makes every effort to maintain the accuracy and completeness of the documents on this website. However, all official records are maintained by the Lead State (or Participating Entity, in the case of participating addenda). In the event of any conflict between the documents on this site and an entity’s official records, the official records govern.
Questions, concerns, and feedback on this website’s content may be sent to [email protected].
What is a Participating Addendum?
A Participating Addendum (PA) is generally used by a state Chief Procurement Official (CPO) to establish a state contract tied to a specific NASPO ValuePoint master agreement. The PA identifies unique terms and conditions specific to a state and identifies state agencies and other eligible entities in the state that are authorized to participate in the agreement. A state CPO may issue PAs that allow participation as follows:
- Statewide provides for participation by all state and local government agencies and other eligible entities within the state
- State only provides for participation only by state agencies.
- Non State entities only provides for participation by local government agencies and other eligible entities, but prohibits participation by state agencies.
Review your state’s Participating Addendum (PA) to determine eligibility. If a PA is not currently in place, contact the state CPO to discuss whether participation may be considered.
For questions related to participation in NASPO ValuePoint master agreements, please contact the Cooperative Contract Coordination team at [email protected].