S0: Advance Planning Documents for Medicaid IT Projects

Notice: applying this to your agency.

The IT Project Resources are not meant to replace your agency’s internal project management practices or prescribe how you must operate. Instead, they offer concepts and tools that can strengthen delivery by providing a scalable framework for project level coordination. All project documentation should be maintained throughout each stage in alignment with agency policies and, where applicable, WaTech requirements and oversight expectations.

This task ensures that any IT project completes the federal Advance Planning Document (APD) process required by the Centers for Medicare & Medicaid Services (CMS) before project initiation. APDs allow the state to request enhanced federal funding at the 90% and 75% federal financial participation rate for planning, implementation, and operations of systems that benefit the state’s Medicaid program and/or population.

The Washington State Health and Human Services Coalition coordinates Medicaid IT investments across its member organizations and it screens all projects prior to inclusion in an APD. You may also contact the APD Team at HCA to determine if your project might be eligible for enhanced Medicaid FFP in an APD.

Projects outside Medicaid follow their standard processes and do not use APDs.

This task identifies whether the proposed work requires an APD and, if so, ensures the program or project prepares the appropriate APD type. APDs are formal submissions to CMS that document:

  • Needs and objectives
  • Requirements Analysis, Feasibility Study, and Analysis of Alternatives
  • State and Contractor Resources
  • Budget and Cost Allocation
  • Acquisition Plan
  • Schedule
  • How project meets the 22 Condition for Enhanced Funding
  • Outcomes and Metrics

APDs must be updated annually and amended as needed when significant changes occur within a federal fiscal year.

When This Task Applies

This task applies only to programs and projects that support:

  • Medicaid Management Information System (MMIS)
  • Eligibility & Enrollment (E&E) systems
  • Other IT systems or services eligible for enhanced Medicaid FFP

If a project does not support Medicaid operations or eligibility, this task does not apply.

For Programs:

Programs that oversee Medicaid IT systems are responsible for:

  • Determining whether planned work requires an APD
  • Ensuring APDs align with program strategy and federal requirements
  • Coordinating with HCA on APD submissions and updates across multiple projects

Programs may have a single APD covering multiple related projects or separate APDs for distinct system components.

For Programs with Agency‑Led Sub‑Projects:

Projects under a Medicaid program must:

  • Provide inputs for APD content (scope, schedule, budget, procurement)
  • Align project planning with the APD timeline and federal approval cycles
  • Track changes that may require an As-Needed APD update
  • Ensure that contracts funded by an APD obtain required CMS prior approvals

A project may:

  • Be fully covered under a program‑level APD, or
  • Require its own APD if it represents a discrete system or major enhancement

For Projects:

Agency‑level projects only complete this task if:

  • The project directly supports Medicaid operations, eligibility, or data systems
  • The agency receives or intends to request Medicaid FFP

WaTech Template: None