Medicaid Management Information System Certification IV&V
SLI is providing IV&V services for CMS and the States of Arizona and Hawaii in support of their implementation of an Electronic Visit Verification Module in accordance with guidelines found in the Medicaid Enterprise Certification Toolkit (MECT).
The two States have a joint agreement where Arizona leads the design, development, implementation, operation and maintenance of the Medicaid system for both States. The Arizona Health Care Cost Containment System (AHCCCS) is the state of Arizona Medicaid agency while Med-QUEST is the Medicaid agency for the state of Hawaii.
AHCCCS and Med-QUEST are implementing EVV within the 2019 timeframe by deploying an Open Vendor Model EVV system. This is a hybrid model allowing the state to contract with one EVV vendor or operate its own EVV system while still allowing providers and Managed Care Organizations with an existing EVV system to continue to use those systems.
Staff from SLI’s Center for Systems Integrity (CSI) will perform monthly reviews using the most recent release of the Medicaid Enterprise Certification Toolkit (MECT) and report to the Center for Medicare and Medicaid Services (CMS) and the states.
Scope of Service:
- Produce exception based Quarterly IV&V Progress Reports that objectively illustrate the strengths and weaknesses of the project and provide recommendations for correcting any identified weaknesses
- Deliver monthly status reports
- Conduct week conference call
- Review and analyze all applicable and available documentation
- Evaluate and make recommendations about the states artifacts that are required for certification reviews
- Provide guidance and assistance following the CMS requirements of the MECL and MECT