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West Virginia Department of Human Services nationally recognized for modernizing Medicaid system

The West Virginia Department of Human Services received national recognition for modernizing its Medicaid Management Information System with cloud-based technology, improving efficiency, security, and service delivery for over 512,000 Medicaid members.

The West Virginia Department of Human Services (DoHS) has been named a 2025 AWS Champions Award winner by Amazon Web Services (AWS) and the Center for Digital Government, recognizing the agency’s successful modernization of the state’s Medicaid Management Information System (MMIS). This transformation strengthens DoHS’s ability to manage large volumes of complex Medicaid transactions with greater speed, accuracy, and security. It will also ensure West Virginians receive the care they need, when they need it, while reinforcing the integrity of the state’s Medicaid program.

This national recognition highlights DoHS’s implementation of Gainwell Technologies’ Claims, Encounters, and Financials (CEF) solution on the AWS Cloud, a critical milestone in transforming Medicaid service delivery across West Virginia.

The project gained national attention at the 2025 State Health IT Connect meeting, where Brandon Lewis, the newly appointed Chief of Technology and Information Systems at DoHS, presented the initiative alongside Gainwell Technologies.

The Gainwell CEF solution, deployed on AWS, now powers the state’s core Medicaid business functions, including claims processing, member eligibility and enrollment, provider enrollment and management, and financial transactions and reporting.

The modernized MMIS now supports:

  • 36 million Medicaid claims annually
  • Managing over $5 billion in Medicaid service payments
  • Over 512,000 Medicaid members and 95,000 providers

“This transformation strengthens our ability to manage large volumes of complex Medicaid transactions,” said Alex Mayer, Cabinet Secretary of the West Virginia Department of Human Services. “It’s a vital step toward ensuring West Virginians receive the care they need, timely and efficiently while protecting the integrity of the Medicaid program.”

Transitioning to the new platform caused minimal disruption for providers, as reflected by low complaint volumes and consistent payment timelines.

“This award reflects our commitment to using innovative technology to improve services for the people of West Virginia,” said Cynthia Beane, DoHS Commissioner of the Bureau for Medical Services. “Our Medicaid system now operates more efficiently, securely, and responsively thanks to this transition. We’re proud to lead the way in creating a more flexible, future-ready infrastructure that puts people first.”

The modular, cloud-native architecture enables DoHS to rapidly adopt new functionalities, respond to federal updates, and scale services efficiently without costly legacy system delays.

“Modernization isn’t just about technology, it’s about delivering meaningful outcomes,” said Brandon Lewis, DoHS Chief of Technology and Information Systems. “By moving to a modular, cloud-native system, we’re ensuring our Medicaid program can respond to policy changes and member needs more efficiently than ever.”

The 2025 AWS Champions Award celebrates public sector leaders nationwide who leverage cloud technology to enhance performance, reduce costs, and improve lives. West Virginia’s success will be featured on the AWS Champions website, launching next week.

To learn more about West Virginia Medicaid, visit dhhr.wv.gov/bms.

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