Precertification Pilot Notice of Intent to Participate and Vendor Profile
To participate in the pilot, please send an email to email@example.com with subject heading “[vendor name] Intent to Participate” and include the information requested below. Note that this notification is required for each distinct module a vendor wishes to pilot.
Once received, CMS will provide additional information for vendors to establish Enterprise Identification Management (EIDM) and access to the Precertification pilot portal.
Business Profile Information & Statement of Capabilities
- Details for the identification of your company, including legal entity name, trade name, mailing address, taxpayer identification number and any additional specifics needed to accurately identify your company and company leadership.
- Examples of your company’s experience in (IT) software product development including a statement of your company’s capabilities and services, software products for healthcare and other industries (as appropriate), descriptions of these products and whether they are currently installed for customers.
- Contact information for at least two individuals who can provide references for your company including name, relationship to your company, business address, telephone, fax and email address.
MMIS Module Submission Information
- The module type your company is submitting including:
- A description (500-750 words) detailing what distinguishes this module from other solutions on the market. This description can include details of your solution’s architecture, design, configurability and customization needs that support Medicaid innovation and modularity.
- The module’s type (such as Pharmacy), key capabilities, platform, the data exchange format, and any interfaces/interactions with other modules or applications.
- Installation requirements such as a specific tech stack (UNIX, Windows-based, etc.), performance requirements (bandwidth, CPU, memory) and configuration options.
- Links to or locations of additional module evidence that is not included on your precertification criteria checklist.
- Levels of technical support (SLAs) your company offers customers, such as 24/7 support, and other configurations.