Features

• Identify Medicaid Enterprise systems in scope
• Provide a detailed MMIS analysis and impacts of systems and interfaces
• Provide a detailed gap analysis of HIPAA rules with existing system
• Identify what transactions are in scope, and what options exist
• Provide a "medium" mapping analysis with claim files and Standard Transactions
• Provide local code analysis and impact assessment
• Evaluate integration of National Provider Identifier

• Enterprise Security analysis
• Enterprise Privacy analysis
• Review and analyze Medicaid Policies, manuals, and procedure documents
• Implementation recommendations, strategies, and cost estimates
• Provide assessment validation using:
• HCFA’s Medicaid HIPAA Compliant Concept Model (MHCCM)
• Specific HIPAA Implementation input for APD development
• Evaluate HIPAA impact to existing DSS and DSS interfaces

Components

• HIPAA Assessment Project Plan
  • Realistic Schedule
  • Defined templates
  • Work Breakdown Structure (WBS)
• HIPAA Requirements Traceability Matrix
  • Interpretative analysis of Administration Simplification, Security, & Privacy

• User-friendly HIPAA transaction layouts
• HIPAA Mapping tools, templates and guidelines
• MMIS Architecture Evaluation
• Environment and functional checklist criteria
  • Based on Medicaid HIPAA Compliant Concept Model
• Security assessment and surveys
• Privacy assessment and surveys

Success Factors

• Extensive working knowledge of State MMIS Environments
• Detailed HIPAA Assessment Templates

• Detailed HIPAA Assessment Questionnaires
• Documented HIPAA Assessment processes, checklists, surveys, etc

Duration

• 60 - 90 DAYS