FY 2016 Appropriation

The current system processing and paying medical claims, the Medicaid Management Information System, started in 1983. A system that began operations in 1975 in Iowa is the basis for the current system. The system uses a programming language known as COBOL. New federal requirements continue to add to the system design requirements and add details to the information required for medical billing and reporting. The Department of Health is replacing the system incrementally by function.

Funding History

Funding Issues

Medicaid Management Information System Replacement

Money is for final phases for the replacement of the Medicaid Management Information System. (The Governor had $3.5 million in his budget). The replacement should be complete in FY 2017. How Measure Success? (once project completed) (1) the timeliness and accuracy of processed claims and (2) the amount of time to enroll a new Medicaid provider
Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $50,614,700 from all sources for Medicaid Management Information System Replacement. This is a 44.5 percent increase from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $5,065,700 from the General/Education Funds, an increase of 152.7 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

In addition to statewide compensation and internal service fund cost increases, the following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time Medicaid Management Information System Replacement$0$50,500,000
OngoingOne-TimeFinancing Source
$0$5,050,000General Fund, One-time
$0$45,450,000Federal Funds
Money is for final phases for the replacement of the Medicaid Management Information System. (The Governor had $3.5 million in his budget). The replacement should be complete in FY 2017. How Measure Success? (once project completed) (1) the timeliness and accuracy of processed claims and (2) the amount of time to enroll a new Medicaid provider

Intent Language

HB0003: Item 81

Under Section 63J-1-603 of the Utah Code, the Legislature intends up to $3,500,000 provided for the Department of Health's Medicaid Management Information System Replacement in Item 72 of Chapter 282, Laws of Utah 2014 shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to the redesign and replacement of the Medicaid Management Information System.


SB0003: Item 121

The Legislature intends that the Medicaid Accountable Care Organizations receive a scheduled two percent increase effective January 1, 2016 consistent with the intent of S.B. 180, 2011 General Session.


SB0007S01: Item 5

The Legislature intends that the Department of Health report quarterly to the Office of the Legislative Fiscal Analyst on the status of replacing the Medicaid Management Information System replacement beginning September 30, 2015. The reports should include, where applicable, the responses to any requests for proposals. At least one report during FY 2016 should include the first estimate of net ongoing impacts to the State from the new system.


SB0007S01: Item 5

The Legislature intends that the Department of Health report on the following performance measures for the Medicaid Mandatory Services line item: (1) percent of adults age 45-64 with ambulatory or preventive care visits (Target = 88% or more), (2) percent of deliveries that had a post partum visit between 21 and 56 days after delivery (Target = 60% or more), and (3) percent of customers satisfied with their managed care plan (Target = 85% or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.


SB0007S01: Item 17

The Legislature intends that the Department of Health report quarterly to the Office of the Legislative Fiscal Analyst on the status of replacing the Medicaid Management Information System replacement beginning September 30, 2015. The reports should include, where applicable, the responses to any requests for proposals. At least one report during FY 2016 should include the first estimate of net ongoing impacts to the State from the new system.


SB0007S01: Item 17

The Legislature intends that the Department of Health report on the following performance measures for the Medicaid Mandatory Services line item: (1) percent of adults age 45-64 with ambulatory or preventive care visits (Target = 88% or more), (2) percent of deliveries that had a post partum visit between 21 and 56 days after delivery (Target = 60% or more), and (3) percent of customers satisfied with their managed care plan (Target = 85% or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.


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COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.