The Centers for Medicare & Medicaid Services (CMS) certification for enhanced Federal Financial Participation (FFP) has changed in significant ways, which means how your state’s Medicaid systems qualify for FFP has changed. PCG’s Certification Management services are designed with your project’s success in mind and provide comprehensive and cutting-edge management based on the new Streamlined Modular Certification/Outcomes-Based Certification (SMC/OBC) requirements.
Certification Management service will provide your state with the knowledge, experience, guidance, and tools to plan, prepare for, and ultimately achieve your ongoing FFP needs. Leveraging PCG’s decades of Medicaid experience, PCM brings valuable lessons learned, leverageable successes, and most importantly, unparalleled expertise to support your certification and funding goals.
Why PCG’s Certification Management Services?
PCG helps states understand and navigate federal regulations and CMS' evolving approach to Medicaid Enterprise System (MES) certification and enhanced federal funding.
As an organization at the forefront of SMC/OBC Certification, PCG will expertly and collaboratively support your organization, either module-by-module or at the enterprise level, through the critical stages of CMS Federal Certification.
Consolidated List of PCG Services:
- Strategic Planning
- System Development Support
- Quality Performance Measurement
- Data Analytics and Management
- System Security Compliance Assessment
- Testing Compliance Assessment
- Governance Support
- Operations and Maintenance Support
Strategic Planning—PCG offers strategies for successful planning and long-term, tactical
development. From assisting states with APD drafting, to establishing product roadmaps and
module sequencing, PCG devises impactful approaches for requesting and receiving
enhanced federal funding. PCG equips states with a comprehensive understanding of
multifaceted federal regulatory requirements.
System Development Support—PCG’s System Development Support covers a wide range of
services which include verification of solution requirements and drafting of CMS certification
intake form. Additionally, PCG supports states with preparation of responses to the intake form
criterion and development of state-specific outcomes/metrics and validation of the proposed
evidence prior to the Operational Readiness Review.
Quality Performance Measurement—PCG’s skilled professionals have helped states craft
strategic outcomes and precise metrics to ensure tangible results and measurable successes;
this serves as a valuable resource for states to navigate these complexities and deliver
impactful solutions tailored to them.
Data Analytics and Management—PCG utilizes the power of data to drive business
successes. Data validation, management, and analytics are top priorities for achieving
business goals and objectives. This work is central to successful CMS certification and
qualification for ongoing – or operational – enhanced federal funding.
System Security Compliance Assessment—System Security is vital to successful CMS
certification and qualification for enhanced federal funding after a system goes live. PCG has
a wealth of industry experience in providing states with seamless execution – as well as
meticulous monitoring – of third-party security assessments. Whether PCG is conducting or
monitoring the assessment, each state’s success remains the top priority.
Testing and System Training—PCG assists states with generating robust testing capabilities
which are aligned with CMS testing guidance framework. This process includes three primary
target areas: quality assurance, effective and dynamic training, and the most ideal testing
resource allocation.
Governance Support—PCG’s wide array of services related to governance promote
transparency, accountability, improved decision-making, risk management, and long-term
sustainability. Strategic OCM planning and data quality assurance are at the heart of these
services. This enables PCG to assist states with MITA State Self Assessments, HIPAA
compliance, risk management and mitigation, and vital PMO functions.
Operations and Maintenance Support—PCG supports states all the way through their
maintenance and operational phases. PCG helps with drafting operational reports for the
CMS Final Certification review. PCG develops the processes and plans in place for the
alternate scenario. PCG believes in working proactively and handling issues in a timely
manner with the ultimate goal of preserving enhanced funding.