The new Open Medicaid IT strategy was codified into law as of December 4, 2015 and it went into effect on January 1, 2016 (see Federal Register | Medicaid Program; Mechanized Claims Processing and Information Retrieval Systems (90/10)). This is a must read. Note that the Federal Rule not only mentions “open” and “open source” 43 times, it actually explains why CMS, in collaboration with the States, has embraced an open source approach to Medicaid IT. This rule breaks standard Federal rule-making in that it wisely leaves many of the specific details of its implementation open to development in collaboration with State agencies and public servants, the health IT industry, and the open source community. Thus the RFI and one of the key the reasons OSEHRA and the OSEHRA community should provide input.