State Government Solutions
The Modern Data Platform State Medicaid Agencies Need.
Tessarix™ and a full suite of purpose-built compliance, analytics, and AI products: FHIR-native, cloud-native, and deployable in minutes, days, or weeks.
The Operating Reality
State Medicaid Agencies Face a Convergence of Pressures
CMS Compliance Demands Are Escalating
T-MSIS reporting requirements, interoperability mandates (CMS-9115-F), modular MES certification requirements, and Outcomes-Based Assessments create a compliance burden that legacy systems were not built to handle. Inaccurate submissions cost states federal matching funds.
Legacy Systems Cannot Keep Pace with Modernization Mandates
Monolithic MMIS architectures take years and tens of millions of dollars to replace. Meanwhile, CMS continues to require modular, API-driven, FHIR-compliant data exchange. The gap between what states have and what CMS requires grows wider each year.
Fraud, Waste, and Abuse Erode Program Budgets
Medicaid fraud costs state programs billions annually. Detection tools built on static rule sets miss adaptive fraud patterns. Modern machine learning (ML) program integrity tools are essential, and most states do not yet have them.
Why Amida
A Different Kind of Medicaid Data Company
Amida's products are built for how Medicaid data works now.
FHIR-Native by Design, Not Retrofit
Amida's products are built on FHIR open standards from the ground up, not adapted from pre-FHIR legacy architectures. This means faster CMS certification, lower integration costs, and natural alignment with the interoperability requirements state agencies must meet.
Products You Own. Not Perpetual Consulting Engagements.
Every Amida offering is a deployable, licensable product with defined capabilities and documented APIs. States get IP they own and operate, instead of expensive open-ended services relationships with billable hours for every change request.
Modern Cloud Architecture. Faster Deployment.
Legacy MMIS implementations take two to five years. Amida's modular, cloud-native product suite is deployable in months. State agencies facing CMS deadlines or mid-cycle modernization needs cannot afford multi-year implementation runways.
AI-Native Data Infrastructure
Amida's Agent Core Platform and DataLoom™ are designed to serve as the foundation layer for AI and Machine Learning applications in Medicaid programs. Your data infrastructure is not just compliant today, it is architected for the analytics and AI tools your program will need tomorrow.
Proof Over Promises
Performance That Tells a Different Story
projected savings versus legacy implementation approaches, on the Tessarix™ platform
generating hundreds of business rules per submission cycle across Lighthouse and DataLoom™
HEDIS/NCQA-aligned measures supported, including all 76 NCQA-certified MY2025 measures via Saraswati
recognized by CMS for explainable AI fraud detection on Medicare claims data
The Product Suite
A Product Suite Built for Every Layer of State Medicaid Data
From cloud-native data platforms to AI-powered fraud detection, CMS compliance tools, and healthcare interoperability, every Amida product is purpose-built for state Medicaid programs.
Tessarix™
The cloud-native data lakehouse for state Medicaid. Unifies Medicaid, CHIP, Medicare, and waiver data on an Apache Iceberg open lakehouse, with T-MSIS validation, HEDIS reporting, and AI-powered analytics built in. 60-65 percent ETL cost savings versus legacy approaches.
Explore Tessarix™Tessarix™
The cloud-native data lake and warehouse for state Medicaid. Unifies Medicaid, CHIP, Medicare, and waiver data on an Apache Iceberg open lakehouse, with T-MSIS validation, HEDIS reporting, and AI-powered analytics built in.
Learn moreDataLoom™
Seven data capabilities in one platform: integration, metadata management, governance, data quality, lineage tracking, profiling, and automated SQL generation. Replace your fragmented tool stack with one integrated, automated environment.
Learn moreTorQE
The only named, standalone T-MSIS file validator in the market. Catch CMS data quality errors before they reach the federal system, not after they generate findings that cost your state federal matching funds.
Learn moreEPS
Medicaid encounter data processed accurately, on time, and in CMS-required formats. Reduces encounter rejection rates and the manual rework cycles that follow every failed batch submission.
Learn moreInteroperability System
Meet CMS interoperability mandates (CMS-9115-F) without replacing your underlying systems. FHIR-native APIs, HL7 message processing, and bulk data exchange in a single compliant platform.
Learn moreLighthouse
Hundreds of validation rules, generated from 40+ configurable templates, applied to your Medicaid data at every stage of its lifecycle. Surface errors and anomalies before they reach CMS submissions, downstream systems, or program reports.
Learn moreMDM Workbench
One trusted identity for every patient, provider, and member across your systems. Real-time, explainable entity resolution powered by Senzing, with stewardship, analytics, and governance built in. Runs in your cloud or air-gapped.
Learn moreProgram Integrity Tool
Fraud is a network crime, and this tool sees the network. Surfaces provider referral rings, phantom billing, and pharmacy shopping schemes that claim-by-claim systems miss, with every flag traceable to its source claims. CMS Crushing Fraud Chili Cook-Off Finalist.
Learn moreSaraswati
Real-time HEDIS and dQM measurement using CQL. All 76 NCQA-certified measures for MY2025, care-gap identification, performance forecasting, and member-level drill-through for payers, providers, and state quality teams.
Learn moreAgent Core Platform
The compliance-ready foundation for deploying AI agents in state government health programs. Security, access control, audit logging, and HIPAA/NIST scaffolding, so your AI deployments are production-ready, not pilot-grade.
Learn moreAI Chatbot
Natural-language access to Medicaid data for members, providers, and agency staff. Text-to-SQL for internal analysts. Handles member inquiries, provider lookup, eligibility status, and benefit questions, at scale, without adding headcount.
Learn moreATP
A low-code AI test automation platform. Write tests in plain English and ATP's multi-agent engine executes them against browser, API, and database layers, with no coding required and audit-ready evidence for every run.
Learn moreAmida Connect
HL7 to modern format conversion for healthcare data pipelines. Unlock clinical data trapped in legacy HL7 format and feed it into FHIR-native analytics environments, without replacing or modifying the systems generating it.
Learn moreRural Health Transformation
Medicaid data infrastructure configured for rural program realities: sparse provider networks, thin encounter data, high FQHC/CAH reliance, and distance-to-care barriers. For state programs where the data challenges are as significant as the clinical ones.
Learn moreSecurity and Compliance
Government-Grade Security. Enterprise Compliance. Built In, Not Bolted On.
PHI protection and access controls across all products
Certified quality management system
Federal security controls, all 20 control families
Independently validated healthcare information security
Deployed in Azure Government (GCC High)
No implicit trust, every access request verified
Authority to Operate documentation for state IT oversight
Active certifications in state Medicaid deployments
Amida products are deployed within a security architecture that meets the requirements of state government CISOs, federal CMS oversight reviews, and HIPAA enforcement standards. Every product in the Amida suite is built on the same HITRUST-certified, NIST 800-53-compliant, Zero Trust infrastructure, not assembled from separate security layers by separate teams. We provide the Authority to Operate (ATO) documentation state IT oversight requires, hold active CMS certifications in state Medicaid deployments, and are FedRAMP-aligned, with assessment in progress.
Recognition
Recognized by the Agency That Sets the Standards
CMS Crushing Fraud Chili Cook-Off: Finalist
Selected by the Centers for Medicare and Medicaid Services as one of ten national finalist teams, applying explainable AI and graph-based network analysis to Medicare claims data to surface novel indicators of fraud. When CMS recognizes a detection approach, state programs can deploy it with confidence.
Product recognized: Program Integrity Tool
North Carolina DHHS: AI/ML Vendor Pool
Competitively selected for NCDHHS's pre-qualified vendor pool for AI and ML modernization, with particular emphasis on Medicaid operations. Teamed with LexisNexis Risk Solutions.
HITRUST e1 Certification
Certified for cybersecurity and information protection, the healthcare industry's benchmark third-party security validation.
CMS Crushing Fraud Chili Cook-Off
Selected as one of ten national finalists for a graph-based approach to fraud, waste, and abuse detection, the method now productized in the Program Integrity Tool.
Procurement View
Capabilities That Cover the Full Medicaid Data Lifecycle
Data Interoperability
Connect legacy MMIS systems, state data warehouses, FHIR endpoints, and CMS reporting pipelines through standards-based integration.
Data Quality and Governance
Apply configurable validation rules, manage data lineage, and enforce data policies across your Medicaid program's full data estate.
CMS Compliance and Reporting
Generate accurate T-MSIS submissions, validate files before submission, and reduce CMS Outcomes-Based Assessment (OBA) findings.
Program Integrity and Fraud Detection
Detect Medicaid fraud, waste, and abuse using graph analytics, predictive scoring, and integrated case management.
Analytics and Data Intelligence
Build a modern data foundation that supports population health analytics, quality measure tracking, and cost trend analysis.
AI and Automation
Deploy AI agents and conversational interfaces that extend your program's capacity without adding headcount, built for the security and auditability requirements of government health programs.
Agent Core · AI Chatbot · ATP
Track Record
Blue Button at the VA. A Statewide EHR in New York. Fifteen Years of Proof.
From New York's statewide EHR to graph fraud detection recognized by CMS to the VA's Summit Data Platform, get the team that changed healthcare IT.
See the Full Track RecordStreamlined Procurement
No RFP Required to Start. Buy Through Carahsoft.
Amida's product suite, including TorQE and DataLoom™, is listed in the Carahsoft catalog, giving state and federal agencies a direct procurement path. Request a quote today, no RFP or RFI cycle needed to begin.
Next Step
Ready to Modernize Your Medicaid Data Infrastructure?
Talk to an Amida expert about your state's specific compliance, data management, or program integrity challenges.
- A real conversation with a Medicaid data architect, not a sales script
- Product overview one-pager available for internal distribution
- Security and compliance documentation ready for your CISO's review