Medicaid Enterprise System Transformation Project

EOHHS is transitioning from the Medicaid Management Information System (MMIS) to a modular Medicaid Enterprise System that we’ve named RI Medicaid OASIS. This is an exciting, long-term, and phased-in project that will ultimately provide Medicaid staff and providers a more flexible, customer-friendly, and innovative system for years to come.

RI Medicaid OASIS: Optimized & Adaptable State Information System

What is the OASIS Project?

EOHHS is upgrading the legacy MMIS to a modern, modular Medicaid Enterprise System called OASIS, aiming to improve user experience, information reliability, and data sharing between systems.

The transformation to OASIS will span a number of years and will involve planning, procurement, and implementation initiatives, in addition to engagement with EOHHS business units and end users to define requirements and test new solutions.

A highly collaborative approach is being used to support this initiative. It includes EOHHS leadership; business, technology, data, and procurement teams; and vendor partners working to support the transformation in a phased-in approach.

Why is Rhode Island doing this?

To introduce Modularity, to upgrade and Modernize, and to coordinate Interoperability of system components. Modularized and modernized systems allow for more flexibility to build in better functionality, optimize interoperability, and ensure compliance with Medicaid/CMS requirements. OASIS will allow EOHHS to procure the “best of” technology and functionality for each portion of the system to support the unique needs of RI.

In addition, the Centers for Medicare & Medicaid Services (CMS) has directed states to transform existing legacy systems (like RI’s MMIS) to modern, modular Medicaid Enterprise Systems (RI Medicaid OASIS). Compliance with this directive is required in order to maintain RI’s ability to apply for and receive Enhanced Federal Match funding.

What is the project timeline?

These dates are subject to change. Please check back frequently for updates. 

OASIS Modules Planned Procurement Method RFP # on OSP* Tentative Posting Date
Third Party Liability (TPL) NASPO ValuePoint Master Agreement N/A 07/01/2024 (Actual Date)
System Integrator (SI) & Operational Data Store (ODS) RFP posted to Ocean State Procures (OSP) Solicitation # RFP25004569 08/26/2024 (Actual Date)
Electronic Visit Verification (EVV) RFP to OSP TBD TBD
Provider Management NASPO ValuePoint Master Agreement N/A 02/20/2025
Core Module RFP posted to OSP TBD 05/28/2025
Surveillance & Utilization Review Subsystem (SURS) RFP posted to OSP TBD 10/30/2025

*Only for Requests for Proposals (RFPs); link to be provided when RFP is posted to Ocean State Procures (OSP).

Note: Only bidders with a qualified NASPO ValuePoint Master Agreement will be allowed to bid on procurements planned via this method.

Third Party Liability (TPL) Module – A solution to identify and manage the recovery of third-party financial obligations for Medicaid assistance provided under the State Medicaid Plan.

System Integrator (SI) & Operational Data Store (ODS) – Services to support the implementation and integration of various modules and components of the MES. This includes single sign on (SSO) and identity and access management functionality as well as a single portal to provide a common user interface and user experience across all modules regardless of the vendor that is contracted for that module. Additionally, a solution and service that includes data services, data modeling, Master Person Index, and legacy data replication.

Electronic Visit Verification (EVV) – A solution to electronically schedule and track personal care services and home health care services end-to-end from submission of the visit data through to claim adjudication and payment.

Provider Management – A solution to provide Provider eligibility and enrollment as well as functions related to Provider’s ongoing participation in the Medicaid program.

Core Module – A solution for management of Claims and Encounters, Member Management (excluding the eligibility & enrollment functionality currently handled by RIBridges), Financial Management functions, and Pharmacy Drug Management.

Surveillance and Utilization Review Subsystem (SURS) – Tools, technology, and services to ensure Medicaid funds are spent appropriately by detecting and preventing fraud, waste, and abuse.