Templates

The State Health Official Letter (SHO) #25-003, released on August 6, 2025 clarifies previous guidance for state reporting on MES projects and will support certification of systems through the SMC framework. To achieve these goals, CMS developed new templates which will be published after Paperwork Reduction Act (PRA) review. Please reach out to your State Officer to get those templates.

Required

• Intake Form- Used to track information about a state’s single Medicaid Enterprise Systems (MES) project undergoing certification
• Operational Report Workbook - States must use this template to submit metrics data
• Monthly Project Status Reporting Template - States must use this template for status reports

Recommended

• Certification Request Letter Template - States must submit the Certification Request Letter to CMS via email to their CMS MES State Officer and MES@cms.hhs.gov to officially request certification
• System Acceptance Letter Template - The required System Acceptance Letter must accompany the Certification Request Letter for any official certification request
• ORR Sample Agenda - An example agenda for an Operational Readiness Review
• CR Sample Agenda - An example agenda for a Certification Review