GSA and CMS continue Medicaid tech vendor collaboration, but its impact is likely limited, experts say

The Centers for Medicare and Medicaid Services and General Services Administration are continuing a partnership that provides Medicaid technology vendors expedited access to the GSA Schedule, but experts say it won’t be a big boost for states to comply with work requirement rules taking effect on Jan. 1.

The partnership, first announced in January, has led to at least five companies getting onto the GSA Schedule, according to a Nextgov/FCW review of GSA records and a Medicaid.gov webpage. The five companies — Big Interview, CITIZ3N, Fleet Health, Findhelp and Optum — are offering technologies that can help states automate Medicaid eligibility checks, detect fraud and connect individuals with social services.

In late July, a Medicaid.gov webpage revealed eight more companies are seeking faster access to the GSA Schedule. Some of those vendors are moving forward with the fast-track pathway, but others are not. 

Clarity Solutions Group heard from GSA about next steps Tuesday and is looking to get a client communications platform known as ClarityLink onto the GSA Schedule.

“The GSA schedule matters to us because Cooperative Purchasing lets states buy from a small vendor without a full procurement ahead of the” Jan. 1 deadline for Medicaid work requirements, Mike McCaman, the firm’s founder, told Nextgov/FCW.

But ITO Health is not proceeding with the expedited pathway because it was not “convinced that obtaining a GSA schedule would simplify the state procurement process,” CEO Rahul Vanjani told Nextgov/FCW.

Pyx Health has also decided not to pursue getting onto the GSA Schedule because “the indefinite-delivery, indefinite-quantity contract vehicle does not easily align with our service model,” according to a company spokesperson.

The GSA partnership is part of a broader CMS strategy to help states that have expanded Medicaid eligibility to implement work requirements. Under the One Big Beautiful Bill Act, those states must verify that certain Medicaid beneficiaries are working, studying or volunteering for at least 80 hours a month to maintain coverage. CMS has also announced over $600 million in low-cost and free Medicaid technologies for states and is working to allow states to use a federal data hub and a mobile-friendly app for eligibility checks.

A CMS spokesperson said vendors interested in getting onto the GSA Schedule should contact CMS directly. Vendors already on the GSA Schedule offering products and services that can help states implement Medicaid work requirements should contact CMS so they can be listed on Medicaid.gov, the spokesperson added.

GSA did not respond to multiple requests for comment about its partnership with CMS.

It’s unclear what levers GSA is pulling to give Medicaid technology companies faster access to the Schedule or how quick the agency is making the process. 

It generally takes companies 6-18 months to get on the GSA Schedule and the agency already has initiatives such as FASt Lane to make the process quicker, according to Shauna Weatherly, president of federal contracting consulting firm FedSubK. 

Potential benefits

Expedited access to the GSA Schedule could help states procure technologies they will need to implement Medicaid work requirements.

“One thing that the Schedules do is they give an opportunity to introduce new vendors into the ecosystem that states might not otherwise be aware of,” which fosters greater competition between small and large companies, Gabe Menchaca, a senior policy analyst at the Niskanen Center, said in an interview.

CITIZ3N, one of the vendors that has worked with CMS and GSA, similarly told Nextgov/FCW that its GSA Schedule gives states another procurement option as they weigh Medicaid work requirements.

But the GSA Schedule “does not necessarily eliminate state procurement requirements, and each agency still has to determine whether and how to use the GSA vehicle,” said Rob Miller, general manager and senior vice president at CITIZ3N.

The Schedule can also help states conduct market research because of published prices for items and services, according to Chris Hamm, CEO of FIN Acquisitions and a former GSA acquisition executive. That transparency could reduce some contracting work required to establish new purchasing vehicles, Miller said. States, for their part, can negotiate prices down from those listed on the GSA Schedule. 

CITIZ3N and other vendors contacted by Nextgov/FCW did not comment on how many states have expressed interest in procuring their technology from the GSA Schedule. Only 40% to 50% of all GSA Schedule holders actually win work under it during a contract’s lifetime, according to Weatherly.

Broader implementation challenges

Though CMS aims to help states procure Medicaid technology, experts contend its efforts will have a small impact on work requirements implementation.

“A software license is only one component of the total cost for states: staff time, retraining, data migration, and ongoing operations and maintenance are the real cost drivers,” said Colleen Pulawski, interim research director at the Georgetown University Beeck Center for Social Impact and Innovation.

Pulawski also warned states against only procuring products on the GSA Schedule and the separate list of discounted Medicaid technologies.

Only relying on those limited sets of products could give states less leverage over data rights, interoperability, exit and transition support, she said. States should instead break up larger Medicaid procurement needs into smaller, staged components to preserve options and mitigate the risk of vendor lock-in, she added.

Other Medicaid experts argue that more GSA Schedule options do not address a burdensome interim final rule explaining how states must implement Medicaid work requirements. 

The rule, which was published in June, makes “unexpected, last minute changes” to Medicaid work requirements, so states should have more time to implement the policy, the Niskanen Center argues in a report released Friday.

One of the rule’s most significant policies holds that Medicaid applicants must provide some kind of proof — on top of medical diagnostic codes — that their health condition prevents them working.

“Introducing such a twist with less than six months before implementation leaves states with scant negotiating leverage over their vendors, little wiggle room for system testing, and no cushion in case things go wrong — almost a given with any technology implementation on such a scale, no matter how good of a job has been done up to then,” according to the Niskanen Center's report.

A Code for America expert previously told Nextgov/FCW that the policy challenge won’t be addressed by CMS’ separate effort to create a data verification hub either.

The CMS spokesperson did not respond to a request for comment on the interim final rule, which Democratic attorneys generals are currently suing to block.