Our review of 35 states indicates that there is more activity now than ever before in the MMIS procurement and implementation space. MMIS solutions have evolved steadily since they were first mandated and funded in the 1970s. During the past four decades, Medicaid data, system processes and architecture, and transaction specifications have been standardized to allow for improved program management and broader health care IT interoperability. The State's current MMIS is over 20 years old, with components that are over 30 years old. The current MMIS needs to be replaced.