CMS Certification Clause Samples
The CMS Certification clause establishes the requirement for a party to obtain and maintain certification from the Centers for Medicare & Medicaid Services (CMS) as a condition for performing certain services or receiving payments under the agreement. In practice, this means that the party must demonstrate compliance with CMS standards and regulations, and may need to provide proof of certification or notify the other party of any changes in certification status. This clause ensures that all parties involved meet federal regulatory requirements, thereby safeguarding the integrity of services provided and reducing the risk of non-compliance penalties.
CMS Certification. All State Eligibility and Enrollment (E&E) and E&E-related implementations must adhere to federal guidance for the State to receive enhanced federal funding for the operation of the E&E and other modular replacement projects. DSHS and the HHS Coalition will seek enhanced funding to the maximum extent possible and therefore the E&E solution, including the design, development, and implementation of the IE&E Platform, will undergo required certification as specified by the Centers for Medicare & Medicaid Services (CMS). Contractor shall fully support this process through all activities and artifacts requested by DSHS and the program's Quality Assurance (QA) and Independent Verification & Validation (IV&V) vendor(s), if used by the project. Refer to Conditions for Enhanced Funding per 42 CFR § 433.112 for a full list from CMS. CMS has begun transitioning its system certification process to one that evaluates how well Medicaid technology systems support desired business outcomes while reducing burdens on states. Additional information regarding Streamlined Modular Certification can be found here: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇.▇▇▇/medicaid/data-systems/certification/streamlined-modular- certification/index.html
CMS Certification. The Contractor must participate in and support all planning activities associated with Federal certification of the MMIS Care Management Solution. Planning activities will ensure that Vermont’s Medicaid Enterprise meets all CMS requirements and performance standards to qualify for the highest eligible Federal Financial Participation (FFP) rate retroactive to the first day of operation. The Contractor will start preparation at the beginning of the project and continue through each step of the design, development, testing and implementation of the Care Management Solution. At the time of full MMIS certification, the Contractor will:
i. Include planning for CMS Certification as part of Project Kick-Off.
ii. Adhere to CMS’ Seven Standards and Conditions in all deliverables.
iii. Map all requirements, gaps, use cases, testing artifacts, workflows, training documents, change management artifacts, and other applicable artifacts to the corresponding MITA Business Area(s) and MITA Business Process(es).
iv. Create a Certification Readiness Plan.
v. Create a Certification Plan.
vi. In conjunction with the State of Vermont Project Team and CMS, will determine which of the Medicaid Enterprise Certification Toolkit (MECT) criteria are applicable to the Care Management project and certification effort.
vii. Meet all MECT criteria applicable to Care Management.
viii. Within three (3) months of contract signing, the Contractor will report to the State of Vermont Project Team which of the applicable MECT criteria it already meets and it will then track and report the status of each criterion through the Work Plan.
ix. With the State of Vermont, will monitor and report changes in federal laws, policies, or regulations that could impact certification criteria. Significant changes will be implemented subject to the Change Management Plan.
x. Develop a CMS Certification Checklist, based on the CMS Certification Toolkit for more information about requirements of the Care Management Solution, see (▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/Research-Statistics-Data-and-Systems/Computer-Data-and- Systems/MMIS/MECT.html), for those processes supported and impacted by the Care Management Solution.
xi. Support the State in all discussions with CMS regarding certification related to the Care Management Solution.
xii. Develop and execute on required and suggested remediation efforts to achieve certification.
xiii. Assist the State in preparing certification documents and reports related to the Care Management ...
CMS Certification. While the SI effort will deliver vital functionality across NM HHS constituencies, a central stakeholder in the work is New Mexico’s Medicaid entity. The HHS2020 initiative will provide new functionality across HSD and benefit enterprise partners, including Aging and Long-Term Services Department (ALTSD), Children, Youth, and Families Department (CYFD), and Department of Health (DOH). A critical outcome of MMISR and the SI effort is CMS certification. The certification effort will require a great deal of time and resources to accomplish. All module contractors are required to fully and carefully plan for CMS certification and to appropriately dedicate staff to certification. Responses to this RFQ must acknowledge an understanding of the importance of certification and provide a quote that demonstrates readiness to effectively take on this critically important activity. See the CMS web site to review the Medicaid Enterprise Certification Checklist. Also see HSD’s cross reference of Medicaid Enterprise Certification Toolkit (MECT) items to MMISR modules on HSD’s Procurement web site. Many of the Addendum 18 MITA Business Area requirements (found in the procurement library) apply to the SI Contractor, including module integration, interfaces, security, orchestration, and data integrity. The selected contractor, in conjunction with the HSD Business Certification team, will ensure the requirements are met and evidence is provided to the State for CMS reviews. Because of the critical role of the SI, the selected contractor must work in close collaboration with State staff and other module contractors to assure successful integration and completion of each module’s certification requirements. Successful integration includes the completion of end to end testing of all requirements. Contractors must budget for resources to allocate their time working to ensure the certification checklist items have been satisfied and evidence is provided to the State for CMS certification reviews. CMS certification is a must-have outcome of the SI and its crucial role on the project. The SI Contractor will support CMS certification through the R2 Operational Milestone review and the R3 Final Certification review. Once the R3 review is completed, the SI contractor will be responsible for ensuring ongoing operational functionality of the entire HHS2020 enterprise in a state comparable to the R3 certified state. CMS is beginning to utilize Outcomes Based Certification (OBC), which may...
CMS Certification. The Contractor is responsible for meeting any new or modified federal standards, conditions or functional requirements for the operation of the DSS/DW and is responsible for ensuring that the maximum allowable Federal Financial Participation (FFP) is granted. Should the Contractor identify at any time any area in which certification or recertification requirements may not be met or any reason for which maximum FFP would not be granted, the Contractor shall notify the Department of the deficiency, present corrective action plans and upon approval by the Department, correct the deficiency. The Contractor is also responsible for ensuring CMS Certification approval within nine (9) months of system implementation and that CMS grants FFP back to Day One (1) of Operation. The Contractor will be liable for the difference between allowable FFP and what is actually received by the Department for the operation of the EDS as required by CMS Certification standards that is attributable to performance or non-performance of the Contractor. These damages will be incurred if Certification is not attained retroactively to Day One (1) of Operations date or if Certification is not attained at all. # Category Performance Guarantee Liquidated Damages Certification must occur on or before June 30, 2018 or an alternate date approved in writing by DCH.
CMS Certification. In order to obtain maximum FFP, the new MEMS must meet CMS requirements for federal certification.