CMS Issues New Guidance to Streamline Medicaid Enterprise Systems Oversight

This week, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official (SHO) letter, “Streamlining Medicaid Enterprise Systems (MES) Templates to Improve Monitoring and Oversight to Ensure Fiscal Integrity.” The guidance updates how states plan, procure, report on, and evaluate their Medicaid Enterprise Systems. 

The SHO letter refreshes the templates and processes states use for Advance Planning Documents and Medicaid Detailed Budget Tables, clarifying expectations for federal approval and cost tracking. It also tightens operational reporting requirements and reaffirms the need for a robust analysis of alternatives when states propose MES investments, ensuring technology choices are justified on performance, cost, and risk grounds. To improve ongoing accountability, the letter outlines clearer expectations for project status reports that document progress, milestones, and corrective actions. 

Notably, CMS is sunsetting the Electronic Visit Verification (EVV) Outcomes-Based Certification and aligning the procurement pathway with its Streamlined Modular Certification approach. The SHO provides request-for-proposal (RFP) checklist guidance to help states reflect the new certification model in upcoming procurements.