One out of every three people in New York State access affordable healthcare through the federal Medicaid program operated by the state’s Department of Health. eMedNY, the fiscal agent of the statewide Medicaid Management Information System (MMIS), ensures 8.2 million recipient’s eligibility is updated in the system in order for approximately 344,000 participating healthcare providers to receive more than $94 billion in Medicaid payments each year.
Providing an Always-On, Real-Time Processing Environment
With the number of people and providers relying on New York’s Medicaid program, it is essential to ensure that claims are reviewed and processed quickly and accurately and that payments are made consistently, on-time and without error.
For three decades, GDIT has been providing the information system that enables claims processing, payments and data management for New York’s MMIS. The eMedNY system is available 24/7/365, providing a real-time processing environment for online eligibility verification, claim submission, status verification and transaction review.
Technology and Partnerships Enable 100% System Availability
Thousands of providers and millions of families rely on Medicaid processing and payments each year in New York. To meet this critical need, we combine our expertise in data center management, cybersecurity and digital modernization to provide an always-on, reliable system. Our service level agreements are some of the strictest and most stringent in our portfolio, yet the eMedNY team has never missed a payment cycle nor incurred an SLA penalty in nearly a decade while maintaining 2 second response times and 100% system uptime.
Our data center brings top tier technical support to the program, drawing on strategic partnerships, including IBM’s mainframe claims process solutions and AWS’s scalable cloud infrastructure that optimize performance, enhance security, and streamline claims processing for users. Additionally, GDIT delivers managed services for the AWS environment, ensuring full operational resiliency and support for 24/7/365 availability.
30+ Years of Consistent Support to eMedNY
In 2023, GDIT processed more than 366 million claims, including 150 million processed in real-time. More than 659 million eligibility verification requests and 189 million claims status requests were processed online with more than 2.4 million remittances issued. These numbers have increased each year since the inception and the GDIT-operated eMedNY system.
In the same year, eMedNY added the NYRx program, the prescription drug payment program for the state. This added an additional 150 million real-time pharmacy transactions to the system each year. And by combining NYRx with the eMedNY program, the state will save roughly half a billion dollars annually.
GDIT’s long-term relationship in support of the eMedNY program for the New York State Department of Health enables us together to ensure millions of New Yorkers have access to vital healthcare services.