MMIS Audit Services |
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PHBV Partners LLP
Effective January 2, 2012, Clifton Gunderson’s Team Health Care has become PHBV Partners LLP. In addition, Clifton Gunderson and LarsonAllen, ranked as two of the nation’s top 20 certified public accounting and consulting firms have merged to form CliftonLarsonAllen LLP (CLA). PHBV Partners is a separate legal entity that will service our regulatory health care clients at the Local, State and Federal Government levels.
State and local spending on outsourced Medicaid Management Information Systems (MMIS) is expected to grow
significantly in the coming years. This is evident in the unprecedented amount of MMIS procurements that have been
released, or are scheduled for release in the near future. MMIS are becoming larger and more complex every day.
Adding to the complexity and risks for agency management is the use of Web-based applications, huge data files,
Service Oriented Architectures, requirements for data exchange, Medicaid Information Technology Architecture (MITA)
initiatives, and Health Insurance Portability and Accountability Act (HIPAA) requirements for the protection of
electronic protected health information (EPHI).
Members of PHBV Partners understand the challenges in managing and overseeing complex
MMIS, whether in-house or outsourced, and have provided effective services to federal and state government agencies
to help them meet these challenges. Our team uses a number of custom-tailored audit and evaluation techniques,
including automated assessment tools, to examine the areas of MMIS operations and information technology most
important to you. These are the areas that provide you with the information you need to assess achievement of
desired results: the effectiveness of programs, systems, activities and functions; compliance with laws and
regulations; and the economy and efficiency with which resources are being used.
Our range of MMIS services includes:
- IT assessments of security, general and application controls, system development, and change management
- Risk assessment (IT and operational)
- Data analysis for fraud and/or utilization
- Business process improvement
- Assessments of operational performance
- HIPAA assessments
- Claims reviews, including Payment Error Rate Measurement (PERM) reviews
- MITA assessments
