Calif. renews Medicaid contract with EDS

Calif. renews Medicaid contract with EDS

California last week awarded a four-year contract valued at $407 million to EDS Corp. to continue to manage Medi-Cal, the state's Medicaid program.

This is the third time EDS has renewed the contract through a competitive bid process, said Stan Rosenstein, deputy director of medical care services for California's Health Services Department.

EDS will run the state's existing Medi-Cal system, processing more than 200 million claims each year and working with more than 80,000 health care providers.

Medi-Cal uses Web health care portals that let providers verify eligibility online, obtain program information and process pharmacy claims.

California was the first state to have online eligibility determination available at the providers' office, Rosenstein said.

EDS had also added a Web function to the system that lets patients with breast or cervical cancer get expedited treatment.

Perhaps the most significant enhancement of the new contract is its emphasis on antifraud efforts, Rosenstein said. 'We always write out specifically what we want the contract to accomplish,' he said. 'This time it contains a comprehensive package on fighting Medicaid fraud.'

Although many states are scrambling to meet the requirements of the Health Insurance Portability and Accountability Act of 1996, California is not, Rosenstein said. 'California already had very stringent privacy requirements, so HIPAA wasn't all that groundbreaking for us,' he said.

Most HIPAA requirements will be met on the current EDS contract, and there will likely be some residual HIPAA work on the new contract, Rosenstein said.

About the Author

Trudy Walsh is a senior writer for GCN.


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