California To Overhaul 30-Year-Old Medicaid Computer System

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California is developing a complex computer system, called Health Enterprise, to replace the system that currently handles Medi-Cal billing, according to a letter from State Auditor Elaine Howle, Capitol Weekly reports.

Medi-Cal is California's Medicaid program.

Letter Details

In the letter -- sent to Gov. Jerry Brown (D) and legislative leaders on Thursday -- Howle said the new system will replace the Medicaid Management Information System that processes Medi-Cal billing and reimbursement payments to physicians, hospitals, pharmacies, clinics and other health care providers.

Howle said the old system must be replaced because "it is about 30 years old, its operations are inefficient, maintenance is difficult and the risk of system failure is high."

She cited complaints about MMIS from officials at the state Department of Health Care Services.

Details of System Overhaul

State officials say California must begin transitioning to a new system by next year, or the state could lose federal funding.

Affiliated Computer Services -- the contractor handling MMIS -- will develop the new system under its current $1.7 billion contract with the state, which runs until at least 2016 (Howard, Capitol Weekly, 4/20).


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