Louisiana Department of Health and Hospitals
BATON ROUGE—The Department of Health and Hospitals (DHH) announced today that Medicaid provider enrollment through the new claims payment system, Provider Recipient Integrated System for Medicaid (PRISM), is now available at www.medicaid.la.gov/PRISM.
The PRISM claims system will replace the current Medicaid Management Information System (MMIS) that is operated by Molina. PRISM will be implemented in phases, with full operations expected in fall 2014. One of the first phases is a required Medicaid provider re-enrollment, which began Feb. 28. All Louisiana Medicaid Provider Enrollment activity (new enrollments, changes, re-enrollment of all existing providers) will be performed by DHH contractors CNSI and Noridian Administrative Services. CNSI is the contractor administering PRISM.
Every Louisiana Medicaid provider is required to re-enroll in the new Medicaid claims system to comply with Medicaid provider enrollment requirements of the Affordable Care Act (ACA) and to continue provider Medicaid reimbursement after the 2014 transition to claims payment through PRISM.
This re-enrollment requirement applies to all providers, regardless of what type of Medicaid provider they are, and whether they are in the Bayou Health plans, the legacy fee-for-service system or both. Providers can enroll in the new system entirely online, but DHH is offering both web-based and face-to-face enrollment training for those who would like more guidance.
"We are available to help providers through every step of this process, especially during this critical re-enrollment phase," said Ruth Kennedy, DHH Medicaid Director. "Timely online enrollment by providers will help ensure a smooth transition from the legacy MMIS system to the new claims system, PRISM. We are starting the enrollment process well in advance of the 2014 go-live date for PRISM because we have more than 30,000 active Medicaid health care providers enrolled in the legacy system who must re-enroll in PRISM this year. Having them enrolled and ready will help us ensure a smoother transition, and minimize any disruptions in providers' cash flow when the switch is complete in 2014."
The PRISM website, www.medicaid.la.gov/PRISM, contains pertinent information for providers about the new system, including training materials, training schedules, answers to frequently asked questions and PRISM Provider Enrollment Unit contact information.
PRISM technology is based on a Centers for Medicare & Medicaid Services-certified system that has been tailored to meet Louisiana's unique business needs for the Medicaid program.
The new system delivers a modern and flexible web-based platform for the state's Medicaid providers. When fully operational in the fall of 2014, the system will also offer Medicaid members access to information about health care services they received through Medicaid so they will have an electronic health history record.
In June 2011, Louisiana selected CNSI, a Maryland-based health care technology services company, to replace the state's current MMIS and fiscal agent operations. CNSI has partnered with Noridian Administrative Services, LLC, which is supporting administrative and health care operations, Magellan Medicaid Administration, Inc., which is providing pharmacy benefit administration support, and several other key service providers. When PRISM is fully operational, CNSI will manage system operations and maintain fiscal agent responsibilities.