Sections and Programs
The Division of Medicaid & Medical Assistance (DMMA) is comprised of three organizational sections: Planning and Development, Support Services, and Service Delivery.
Planning and Development
This section is responsible for creating and managing the portfolio of DMMA programs with the goal of maximizing benefits to clients while assuring efficient, effective use of taxpayer resources.
The Planning and Development Section is comprised of the following units:
- Program Development, Policy Planning and Evaluation. This unit specifies and develops programs and policies, taking into consideration fiscal impacts, technology requirements, and program performance expectations. It performs research and multi-component data analysis and maintains the state plan. It develops program measurements; manages public relations and communication with stakeholders for compliance activities.
- Managed Care and Quality Assurance. This unit works closely with the Managed Care Organizations (MCOs) serving Medicaid and Delaware Healthy Children Program clients. It also provides the quality assurance function for DMMA programs.
- Vendor Relations/Contracts. This unit develops and manages contracts and Requests for Proposals (RFPs). It sets vendor performance expectations and vendor requirements. The unit is responsible for monitoring vendor credentials, managing claims resolution, handling vendor complaints, developing vendor procedure manuals, imposing corrective actions, and providing vendor education.
This section is led by the DMMA Chief Financial Officer. The purpose of the Support Service Section is to help DMMA execute its core process at an optimal level by providing training, technology, financial resources, facilities and information. The Support Services Section is comprised of the following units:
- Facilities and Supplies
- Staff Development Unit
- Financial Management: Third Party Liability and Estate Recovery, Accounting, Budget and Data.
- Technical Support
The Service Delivery Section has offices throughout the state that determine eligibility for all DMMA programs with the exception of the Delaware Prescription Assistance Program. DMMA has a contractor, Electronic Data Systems (EDS) that determines eligibility for the Delaware Prescription Assistance Program.
This section also contains the DMMA Customer Relations unit, which is responsible for handling customer inquiries and complaints.