HEALTH

eMedNY System Elevates Medicaid Payment Efficiency, Providing Healthcare Access to Millions of New Yorkers

7.9M
active eMedNY Medicaid recipients enrolled
$94B
in Medicaid payments this year
366M
claims processed annually, including 150M real-time pharmacy claims
100%
system uptime
$500M
annual savings to NY State

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.

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.

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.

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.