Introducing CertifyMed: The Complete HCBS Platform Built for Modern Medicaid Programs

What Is CertifyMed?

CertifyMed is a purpose-built enterprise software platform for Home and Community-Based Services (HCBS) 1915(c) waiver programs. It unifies clinical assessments, compliance management, case coordination, program administration, and safety reporting in a single connected system — designed for the operational realities of state Medicaid agencies, managed care organizations (MCOs), assessment entities, and HCBS provider organizations.

Unlike general-purpose healthcare platforms retrofitted for HCBS, CertifyMed was designed from the ground up around the regulatory frameworks that govern Medicaid waiver programs: the HCBS Settings Final Rule, CMS reporting requirements, the Money Follows the Person demonstration, and the clinical protocols embedded in tools like InterRAI.

The Problem We Solve

Running an HCBS program today means operating across a fragmented landscape of spreadsheets, legacy systems, paper-based workflows, and disconnected point solutions. The consequences are real:

• Assessment data sits in one system; service plans in another; incident reports in a third
• Compliance monitoring is reactive rather than proactive — teams discover problems after audits
• Federal reporting requires weeks of manual data pulls and assembly
• State agencies and providers operate with fundamentally different views of the same participant
• New federal requirements (like the HCBS Settings Rule) require custom workarounds in systems never designed for them

CertifyMed replaces fragmentation with a unified operational core — one platform that every stakeholder in the HCBS ecosystem can access with the information and tools relevant to their role.

HCBS programs have some of the most complex regulatory requirements in all of healthcare. We built CertifyMed specifically to absorb that complexity so that teams can focus on delivering quality care.

Core Platform Capabilities

InterRAI Assessments

CertifyMed includes a comprehensive digital InterRAI platform supporting intellectual disability, mental health, and long-term care evaluations. Clinicians complete structured assessments through guided digital workflows, with automated scoring, embedded decision support, and CMS-compliant output generation. Assessment history is retained longitudinally, giving case managers and supervisors a complete clinical picture at every point in a participant's journey.

HCBS Settings Rule Compliance

The HCBS Settings Final Rule introduced some of the most complex compliance obligations in the history of Medicaid long-term services and supports. CertifyMed provides an end-to-end compliance management system: site assessments, heightened-scrutiny tracking, remediation planning, evidence collection, and CMS submission documentation — all connected to participant and provider records.

Case Management

Individual support plans, service authorizations, utilization monitoring, and care team coordination are managed through a unified case management module. CertifyMed supports multi-disciplinary care teams with role-based access, secure internal messaging, and automated workflow triggers — so coordinators spend less time on administrative tasks and more time on participant outcomes.

Program Management

Whether you're running a Money Follows the Person demonstration, a self-direction program, or a complex CMS waiver, CertifyMed's Program Management module provides the enrollment workflows, transition pipeline tracking, longitudinal outcome monitoring, and federal reporting infrastructure to operate every program with consistency and compliance confidence.

Adverse Incident Reporting

CertifyMed's incident management system connects frontline staff, supervisors, clinical reviewers, and state oversight agencies in a single workflow. Incidents are captured through guided intake forms, assigned to investigators, tracked through resolution, and submitted to state agencies — with a complete, tamper-evident audit trail at every step.

Who CertifyMed Is Built For

CertifyMed serves the complete HCBS stakeholder ecosystem:

• State Medicaid Agencies — oversight, reporting, program administration, and CMS compliance
• Managed Care Organizations — quality management, provider oversight, and care coordination
• Assessment Entities — clinical workflows, scheduling, and outcome tracking
• HCBS Provider Organizations — service delivery, incident reporting, and plan implementation
• Case Management Agencies — caseload management, support plan creation, and service tracking

Availability

CertifyMed's InterRAI Assessments and HCBS Settings Rule Compliance modules are available beginning July 1, 2026. Case Management, Program Management, Adverse Incident Reporting, and the full enterprise Quality & Compliance Suite will be available January 1, 2027.

To schedule a walkthrough or discuss how CertifyMed fits your organization's needs, visit our contact page or request a demo.