Chapter 4 - CMS Certification Milestone 2: APD Development

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Primary Guidelines Medicaid Enterprise Certification Roadmap, Chapter 3, First Protocol
Primary Methodology State- or Vendor-specific Methodology
Input Annotated MECT Checklists
Primary Activities Assembling MECT Checklists
Output Completed MECT Checklist Package for APD
Downstream Activities Supported RTM Development for the Resulting RFPs

Introduction

The Medicaid Enterprise Certification Roadmap calls for development of an IAPD and APD for the plans to close the gaps identified as part of the Gap Analysis. To assure that the state and CMS have a shared understanding about what is being requested for approval and funding, CMS requires the submission of SMA goals and objectives, (from Milestone 1), with the IAPD. CMS requires the submission of annotated MECT Checklists with the APD. CMS instructs states to use the First Protocol in Chapter 3 of the Medicaid Enterprise Certification Roadmap documentation to develop the annotated checklists. CMS also requires that the SS-A be submitted with the APD.

Figure 4-1: States must achieve 6 CMS certification milestones to receive federal funds for their IT investments

ReadyCert’s design aligns directly with this protocol, eliminating the need to repeat like-work activities. MECT Checklists have been created as part of the SS-A. Annotated MECT Checklists have been created as part of setting [Goals and Objectives in Milestone 1]. The SS-A is ready for submission to CMS via ReadyCert or traditional office automation formats, such as Word, Excel or PDF files.

The activity descriptions in this section of ReadyCert 6CM address the requirements of CMS’ First Protocol. The process of assembling, reviewing and approving for submission the entire APD package is covered in the overall project management methodology.

Select MECT Checklists (First Protocol, Step 1)

The MECT Checklists have been selected as part of Milestone 1. CMS requires that any checklists that are not selected be marked "Not Applicable." ReadyCert automatically enters, "Not Applicable" on any Business Objectives and corresponding MECT Checklists that are identified during BPM mapping as not applicable to the SMA. Further, the MECT Checklists that correspond to the plans to close the gaps, as identified in the Gap Analysis, are available in ReadyCert. This set of checklists may be a subset of the total. Depending on the request being made via the APD, the SMA may use the entire body of MECT Checklists or a subset.

The MECT Checklists are generated as part of the SS-A and contain linkages to assessment values and supporting evidence. This information is useful to the SMA as it prepares the MECT Checklists for the APD. The linked information helps the SMA advance its understanding of the Medicaid solution needed to satisfy the vision and goals of the Medicaid Enterprise. The linked information is available to CMS as part of the SS-A submitted with the APD.

Tailor MECT Checklists for ADP Use (First Protocol, Step 2)

CMS requires the focal point for the MECT Checklists submitted with the APD be the Business Objectives. However, it requires the SMA to verify several items, each of which is facilitated and enforced by ReadyCert.

  • Business Objectives that are not supported by the SMA should be marked "Not Applicable." These values, if any, are automatically entered during BPM mapping for business processes not supported by the SMA.
  • Business Objectives that are federally mandated may not be marked, "Not Applicable." ReadyCert will not allow the federally mandated business processes to be missed during BPM mapping. Therefore, each federally mandated process is represented in the MECT Checklists selected for submission with the APD.
  • The SMA should review and fully understand the SRC associated with each Business Objective. ReadyCert has the SRC for all Business Objectives pre-loaded, facilitating review and understanding by the SMA.
  • The SRC should be deleted from the MECT Checklists submitted with the APD. ReadyCert allows the SMA to print summary views, absent the detailed SRC.

Each of CMS’s required actions in Step 2 of the First Protocol are supported by the features and functions of ReadyCert.

Complete the MECT Checklists for APD Submission (First Protocol, Step 3)

CMS requires the SMA to review Business Areas and Business Objectives to fully understand the magnitude and complexity of the plans to close gaps and to verify that the planned Medicaid solution will satisfy all goals and objectives. This process has been completed as part of the SS-A and in Milestone 1, State Goals and Objectives. However, CMS gives specific actions that it expects states to take in this step, each of which is facilitated by and enforced by ReadyCert. A summary of the actions CMS expects as part of this step, and the associated support provided by the ReadyCert software, follows:

  • The SMA should review each Business Area and Business Objective. This has been completed as part of the SS-A and Milestone 1. The output of those reviews is resident in ReadyCert.
  • Business Objectives should be added for state-specific objectives, which have been completed as part of the SS-A. The output is resident in ReadyCert.
  • States should create SRC for state-specific Business Objectives. Each new Business Objective is set-up using the same format as the federally mandated Business Objectives. At this point, the SRC is blank for state-specific Business Objectives. The state may enter the SRC at this time, or wait until it progresses to the next Milestone, RFP Development, (inclusive of proposal development, evaluation and contract execution). It is recommended that the SRC be developed at this point, while other SRC is being reviewed. By accessing the applicable MECT Checklist item, SRC is entered in ReadyCert and state-specific objectives are displayed in the same format as federally mandated objectives.
  • The SMA should determine if any state-specific Business Objectives requires additional checklists. During BPM mapping, the state identified all business processes that are required but not represented in the MITA BPM. State-specific business processes have already been added to the appropriate MECT checklists. In the case of entire Business Objectives that are required but not represented in the MITA BPM, new checklists have already been created.

Review the MECT Checklists Submitted with the APD (First Protocol, Step 4)

The CMS RO reviews the MECT Checklists submitted with the APD to increase understanding of the state’s plans and improve the communication between the SMA and RO. ReadyCert facilitates CMS RO review by allowing the state to share the ReadyCert screens with the CMS RO. All of the output can be produced as Word, Excel and PDF files, as required. However, the ability to scroll through the checklists and navigate from one section to another greatly facilitates the review process.

Use the MECT Checklists (First Protocol, Step 5)

CMS requires the MECT checklists be used for downstream RFP development, which is automatically facilitated by ReadyCert. The methodology for using the output from this and preceding work activities to develop the RTM for the resulting RFPs is described in Chapter Five.

Maintain the MECT Checklists (First Protocol, Step 6)

CMS requires that the MECT checklists be updated as change is introduced throughout the Medicaid Enterprise Certification Roadmap. ReadyCert provides a seamless, transparent way to keep the MECT Checklists updated.

When there is a change, regardless of the type of change, an authorized user makes it and saves the new MECT Checklist. Prior versions are maintained in archive so the PMO has a positive audit trail of changes. Alerts are configured to notify applicable users that changes have been made to the MECT Checklists. The users can then decide if the changes need to be more broadly communicated.

Notes