Streamlining Medicaid Enterprise Systems Templates
On August 6, 2025, CMS issued State Health Official (SHO) letter #25-003, providing updated guidance regarding state compliance with regulatory requirements for Medicaid Enterprise System (MES) modules and solutions. This guidance streamlines existing processes and standardizes templates to strengthen states’ ability to meet federal requirements for enhanced federal financial participation.
As of December 23, 2025, the MES templates have received approval under the Paperwork Reduction Act (PRA) from the Office of Management and Budget (OMB) and are formally cleared for use. The use of these templates will be required effective July 1, 2026. CMS encourages states to begin transitioning during the six-month implementation period to ensure an orderly and efficient cutover.
The adoption of standardized templates across the MES lifecycle will expedite funding reviews, promote the evaluation of alternative solutions and reuse opportunities, standardize reporting against Advance Planning Document (APD) milestones, and support a unified certification process for all MES modules. Collectively, these updates strengthen project oversight and enhance CMS’s ability to respond effectively and efficiently to states’ MES needs.
Below is a list of templates that states are required to use for Medicaid IT projects:
- MES Advance Planning Document (APD) Template: States must submit the completed MES APD template for four APD submission types (Planning, Implementation, Update, and As-Needed). The template allows for individual or combined Medicaid Management Information System (MMIS) and Eligibility and Enrollment (E&E) submissions.
- MES Operational APD (OAPD) Template: States must submit the completed MES OAPD template for all OAPD submissions, whether for MMIS, E&E, or both.
- MES Medicaid Detailed Budget Table (MDBT) Template: States must include the completed MES MDBT template in all APD submissions. The template uses a standardized structure for submitting detailed budget table data for individual or combined MMIS and E&E submissions, reducing the number of different files involved in the APD submission process.
- Operational Report Workbook (ORW): States must use the ORW and submit monthly operational reports for enhanced federal match to maintain compliance with 42 CFR § 433.112(b)(15). The ORW standardizes data submission formats to improve data consistency and quality and streamline reporting.
- Analysis of Alternatives (AoA) Template: States must include the completed AoA template in all APD submissions to evaluate the strengths, weaknesses, risks, and benefits of various MES solutions and reuse opportunities. The template helps standardize compliance with 45 CFR § 95.610(b)(3) and reduces the administrative burden of reporting on AoA and reuse.
- Project Status Report Template: States must use the Project Status Report template to submit monthly project status reports that provide timely updates on funding request status, risks, milestones, and progress. The template uses a standardized format to create more consistent project expectations across states and improve project oversight.
- MES Procurement Document Checklist: States must include a completed checklist with all procurement instruments, including Requests for Proposal (RFPs), Requests for Quote (RFQs), and other related solicitations, submitted to CMS. The template uses a standardized format to improve consistency in procurement planning and review and to facilitate alignment with state acquisition strategies.
- Streamlined Modular Certification (SMC) Intake Form: States must use the SMC Intake Form for assessment of all MES modules, including MMIS, E&E, and Electronic Visit Verification (EVV), and submit all necessary evidence and artifacts. The SMC Intake Form fully replaces the EVV intake form.
States are encouraged to reach out to their State Officer for more information.
MES Templates
States can download the MES templates for use:
• MES APD Template
• MES OAPD Template
• MES MDBT
• Operational Report Workbook
• AoA Template
• Project Status Report
• MES Procurement Document Checklist
• SMC Intake Form