Capture revenue, control variance, and submit defensible CMS-64 outputs.

Defensible CMS-64 output in 5 business days. No system access. No PHI.

Recover underreported federal share, attribute variance at line level, and return submission-ready outputs aligned to OBA scoring and federal response requirements.

Protects federal funding, supports OBA expenditure scoring, and strengthens submission defensibility.

Captures underreported federal share tied to prior CMS-64 submissions.

Not reporting software. Not generic analytics. Not consulting labor.

No system access No PHI No security review delays Execution begins immediately — no onboarding cycle required
Federal Scrutiny Has Changed
60-day federal response windows are now enforced on flagged submissions
OBA scoring ties reporting quality directly to federal funding outcomes
T-MSIS / CMS-64 mismatches now trigger automated federal review
Post-submission "pay-and-chase" models are no longer viable under federal enforcement
Submission Risk Surface

Submission risk now directly impacts federal funding release

Federal share variances trigger funding deferrals
OBA scoring failures reduce contract performance ratings
Unresolved discrepancies escalate to corrective action plans
Response windows compress to 60 days with full audit expectations

Medicaid program directors, delivery leads, and T-MSIS/reporting owners within prime contractors.

Revenue Capture & Variance Defense

Capture Revenue. Control Variance. Defend Every Line Item.

Recover underreported federal share, identify and attribute variance at line level, and return defensible CMS-64 outputs before submission triggers funding deferrals, OBA penalties, or corrective action plans.

Required inputs: CMS-64 extracts, supporting schedules, and prior-quarter reports.

Delivered as a submission-defense package with line-item attribution and variance narratives.

What We Detect & Recover
Underreported federal share (recoverable revenue)
FMAP misalignment
Category misclassification
Prior-period adjustment leakage
Line-level allocation errors
T-MSIS / CMS-64 cross-submission mismatches
What You Receive
Federal share variance quantified, attributed, and defensible by line item
Submission workbook (defense-ready, audit-documented)
Reconciled CMS-64 totals ready for submission
Line-item variance attribution and exception support
Quantified federal share variance exposure
Variance narratives and exception logs structured for federal audit defense and response submission

Revenue captured. Variance controlled. Every line item defensible before submission.

Where Certix Fits

Built for live Medicaid reporting programs under delivery pressure.

Engagements are scoped only where the work is reporting delivery on live programs.

In Scope
Where Certix engages
Prime contractors delivering Medicaid programs
CMS-64 / T-MSIS accountable teams
Delivery leaders responsible for CMS reporting accuracy
Out of Scope
Where Certix does not engage
States procuring new systems
Teams looking for analytics dashboards
Long procurement cycles
When Engagement Begins
Correction windows are closing
Reconciliation does not tie
CMS deadlines are approaching
Internal team is overloaded
Engagement Structure
No system access required
No MES integration
No direct PHI handling
Fixed 5-day delivery window
These are recoverable. We capture the revenue, control the variance, and defend the output.
Where Programs Lose Revenue and Fail Federal Review

Federal share underreporting. Expenditures eligible for higher federal matching go unclaimed because FMAP rates are applied to the wrong categories.

Lost federal reimbursement every cycle.

FMAP misalignment. Federal matching percentages don't match actual expenditure categorization. The variance compounds silently across quarters.

Systematic underpayment. Recoverable but unclaimed.

Category misclassification. Expenditures reported under incorrect CMS-64 line items. Federal share calculated against wrong rates.

Recoverable federal share buried in misclassified data.

Prior-period adjustment leakage. Adjustments from prior quarters not reconciled to state accounting. Incomplete carry-forward creates compounding funding gaps.

Cumulative loss. Grows every quarter left unaddressed.
Representative output. Revenue captured. Variance controlled. All validation checks passed.
View sample output →
Engagement Structures
Fixed-scope execution engagements.
Most revenue loss and compliance failures surface after submission — when correction cost is highest and federal review exposure is already locked in.
Per Submission
Fixed-fee revenue capture, variance control, and defensible output. 5-day turnaround.
Submit CMS-64 Data →
Migration Support
Mapping and reconciliation for new reporting templates and T-MSIS transitions.
Submit CMS-64 Data →
CAP / Recovery Support
Targeted variance attribution for programs under federal review or corrective action.
Submit CMS-64 Data →
See What We Deliver

Sample Submission Defense Output

Certix execution package: line-item variance attribution, FMAP-applied share computation, validation log, variance narratives and exception logs structured for federal audit defense and response submission.

Built against public CMS-64 line-item structures for multi-state Medicaid programs.

View sample output →
Submission Defense Package — Revenue captured · Variance controlled
CMS-64.xlsx
variance_attribution.csv
validation_log.json
audit_trail.pdf
prior_period_delta.xlsx
submission_defense_manifest.json
16 / 16 checks passed · revenue captured · variance controlled
WHY NOW

Why this matters now

CMS reporting requirements have tightened. T-MSIS V4.0 is enforced. OBA scoring ties submission quality directly to federal funding outcomes. 60-day response windows are now standard on flagged submissions.

Uncaptured revenue and undefended variance compound across cycles. Each submission without pre-audit variance attribution increases federal review exposure and remediation cost.

Revenue capture and submission defensibility are now funding risks, not operational details.

We capture revenue, control variance, and return defensible outputs.
You own the program.
Certix executes CMS-64 revenue capture, variance control, and submission defense. Defensible output in 5 business days.
01

Revenue Capture & Variance Attribution

Underreported federal share identified and recovered. CMS-64 and T-MSIS packages reconciled against current CMS validation rules with line-level variance attribution.

Revenue captured. Variance controlled. Output defensible.
02

Reporting Workload Absorbed

Reporting cycles run on Certix capacity. Volume scales per cycle, not per hire. No staffing delays during reporting windows.

Capacity without hiring risk. No missed cycles.
03

Audit Documentation Included

Data lineage, transformation logic, and submission defense evidence ship with every deliverable. Reduces audit exposure from day one.

Audit-ready at delivery. No reconstruction needed.
04

Current CMS Rules

Submission defense built against current CMS acceptance criteria. Executed under prime governance. No outdated rule sets.

Rejection risk reduced at delivery.
Data Handling

US-Based Processing

Stateless architecture. No persistent storage of government data.

Auditability

Rejection Defense

Deliverables structured for federal audit review and formal response submission.

Governance

Regulatory Alignment

Aligned to current CMS reporting structures and validation expectations.

Deferral Response Support
Documentation aligned to CMS deferral response requirements
Structured outputs for 60-day resolution windows
Variance attribution supporting release workflows
Three engagement structures.
Capture revenue. Control variance. Defend the output.
Fixed-scope engagement paths for CMS-64 revenue capture, variance control, and defensible submission outputs.

Most revenue loss and compliance failures surface after submission — when correction cost is highest and federal review exposure is already locked in.

Per Submission

Fixed-fee revenue capture, variance control, and defensible CMS-64 output. Identify underreported federal share and attribute variance before submission. 5-day turnaround.

What you get
  • • Submission workbook + exception log
  • • Variance narratives structured for federal review
  • • Submission-defense ready output
Submit CMS-64 Data →
Recommended

Migration Support

Mapping and reconciliation for new reporting templates, T-MSIS transitions, and CMS-64 structure changes. Revenue capture, variance control, and defensible output included.

What you get
  • • Full variance attribution + T-MSIS bridge mapping
  • • Variance attribution with quantified federal share exposure
  • • Exception logs aligned to OBA scoring criteria
  • • Submission-defense documentation package
Submit CMS-64 Data →

CAP / Recovery Support

Targeted variance attribution for programs under federal review, corrective action plans, or active deferral resolution. Defense-grade documentation.

Who this is for
  • • Programs under CMS corrective action or deferral
  • • Federal review response within 60-day windows
  • • Variance attribution supporting recovery workflows
Submit CMS-64 Data →

How every engagement runs.

Four phases. Revenue capture, variance control, and defensible output — in one fixed-scope motion.

Deliverables structured for federal audit review and formal response submission.

Supports OBA expenditure scoring targets and submission defensibility.

Submit CMS-64 Data Securely
Engagement Structure
Phase 1 — Intake
Scope, data sources, environment
Phase 2 — Mapping
T-MSIS + CMS structure alignment
Phase 3 — Validation
Validation checks, variance attribution
Phase 4 — Delivery
Submission-defense package + variance narratives + audit documentation
Ready to deploy under your prime.

No procurement cycle required. Scoped, priced, and deployable within your existing contract vehicle.

Typically funded under remediation, CAP, or compliance stabilization workstreams — not a new software line item.

Download Capability Statement (PDF)
NAICS541519 • 541611 • 541618
541519 Other Computer Related Services • 541611 Administrative & General Management Consulting • 541618 Other Management Consulting
Engagement ModelFixed-scope • Fixed-deliverable • No open-ended retainers
Subcontract RoleExecution layer under prime governance — zero integration lift
Subcontracting FitCMS-64 revenue capture, variance attribution, submission defense
AvailabilityDeployable now under prime-led Medicaid system integrators
Risk PostureNo MES access • No PHI • No schema changes required
SDBSmall business, SDB-eligible (pending SAM registration)
Submit your CMS-64 data.
Submit CMS-64 data and receive a defensible output package within 5 business days. Revenue captured, variance controlled, and outputs aligned to OBA scoring and federal response requirements.
› Per Submission › Migration Support › CAP / Recovery Support

Data Review Request

Direct Contact

US-based secure environment. All inquiries confidential.

Outputs structured for revenue capture, variance control, submission defense, and federal review standards.

Security posture aligned to federal data environment expectations.