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MECT 2.3: More guidance, more documentation


Here we go again! With the 2018 Medicaid Enterprise System Conference (MESC) underway, we have another Medicaid Enterprise Certification Toolkit (MECT) Release. On July 31, 2018, the Centers for Medicare and Medicaid Services (CMS) issued the MECT Version 2.3. Historically, CMS has updated their certification toolkit and lifecycles iteratively on a near yearly basis. With increasingly rapid technological advances and initiatives, CMS’ iterative releases of the MECT are provided in an effort to stay current with federal regulations and industry priorities.

Last year’s MECT update (version 2.2) brought a slew of certification checklist updates, with somewhat comprehensive changes to the certification criteria. Although there were still a few updates to the checklists, this year’s release focused more on updating the required documentation and processes, than revamping the checklists.

Many states are beginning work on Medicaid Information Management System (MMIS) modular procurements, to replace outdated or poorly functioning enterprise and legacy systems. States are continuing to conform the certification process to modern procurements; however, there is still gray area and differences in approach amongst states across regions. Certification teams eagerly await MECT updates as the Toolkit becomes more aligned with new modular procurements. Will MECT 2.3 accomplish that? Let’s look over some of the core certification elements, and consider the impacts. Are we collectively there yet, or do we still need to continue growing through the modular implementation pains?

CMS Certification Checklist Updates

The most impactful update to the certification checklist includes the comprehensive removal of the Medicaid Information Technology Architecture (MITA) Business Area Checklist Set. This removal is a nod to the ever changing Medicaid environment, where MITA-guided procurements are being replaced by modular business function mappings. Additional changes to the checklists include:

  • Provider and Pharmacy checklists now include guidance tabs
  • Program Integrity checklist now includes 6 additional certification criteria for Electronic Visit Verification (EVV) certifications
  • Criterion TA.SP.75 was removed from the Access and Delivery checklists, and added to the Programmatic checklist in the IV&V Progress Report
  • Two criteria, TA.DC.5 and TA.DC.6, were removed from the Intermediary and Interface checklists

Appendix D: MMIS IV&V Progress Report Updates

  • Section instructions have been updated for all sections to include more detail and guidance

  • General Information now includes fields for submitter company name and if/when the Project Partnership Understanding (PPU) document was sent to CMS. Activity 1 Consult Date and RFP release fields have been removed

  • Summary of Project Progress and Status (formerly Executive Summary) instructions now direct the submitter to provide project-wide information, not just planned modules and/or seeking a Milestone Review

  • Budget & Schedule Metrics (formerly Life Cycle Status and Schedule) now includes the ability to identify project and module state-specific metrics to report variance

  • Life Cycle Status and Schedule replaced the MITA-Aligned Modules with Additional Modules to allow states to identify up to five (5) custom modules

  • Risks and Recommendations instructions have been updated to direct the submitter to include project-wide information, not just planned modules and/or seeking a Milestone Review

  • Programmatic Checklist now includes a “partially meets” assessment option

Required Artifacts (Appendix B) Updates

  • One new artifact: New Medicare Card Program’s (NMCP) State Medicaid Agency Readiness Report (R1, R2, and R3)

  • No removed artifacts

  • One artifact with updates: Production Screenshots, Reports, and Data (R3)

Updates to the MECT Appendices

  • Multiple updates to Appendix H: PPU Template, including updates to the section names, removal of multiple sections, and additional guidance on the use of this document

  • Addition of Appendix K: Map of MITA Business Areas to Criteria (This document maps all of the MECT checklist criteria outside of the five core checklists to their appropriate MITA business area)

  • Addition of Appendix L: Milestone Review Preparation Guide (This document explains how milestone reviews are conducted and how states can readily prepare for milestone reviews)

Additional Updates

  • Updates to the Medicaid Enterprise Life Cycle (MECL)

  • Updates to the MECL and At-a-Glance Sheets

  • Additional recommendations for Independent Verification and Validation (IV&V) vendors, including when and how IV&V can provide advice to states

  • Minor updates to additional MECT appendices

From initial assessment of the MECT 2.3 release, it is clear that CMS continues to take strides to align the certification process to support our new modular Medicaid enterprise world. Keep in mind that MECT 2.3 is the latest round of a continuous cycle. Though it will likely not be the answer to all states’ issues and needs, this release does make great strides in adapting to the ever-changing Medicaid landscape. As we reported last year with the release of MECT 2.2, CMS continues to foster and support an environment for states to better align their procurement and certification efforts with the new modular enterprise industry.

Topics: MESC 2018, Medicaid