IRVING, Texas, Oct. 28, 2025 (GLOBE NEWSWIRE) -- Gainwell Technologies today announced the launch of the HMS Community Engagement Verification (CEV) solution, a first-of-its-kind, independent platform that helps states ensure eligible Medicaid members maintain coverage while meeting federal community engagement requirements—without the complexity or cost of re-engineering existing eligibility systems.

With federal deadlines approaching, states face unprecedented operational challenges in verifying participation in community engagement activities while ensuring eligible individuals remain covered. The CEV solution provides a flexible, low-cost, and high confidence pathway that reduces administrative burden, minimizes risk, and supports continuous access to care.

“States should not have to endure heavy costs by re-engineering core eligibility systems to meet new federal mandates, only to spend more money when regulations change in the future,” said Bill Allison, Gainwell Chief Client Officer. “HMS Community Engagement Verification enables states to move fast, verify accurately, and protect continuity of coverage for the people Medicaid serves.”

Fast, Flexible, and Proven

Built on over four decades of HMS expertise in Medicaid verification and cost containment, the CEV solution combines AI-driven automation, precision data matching, and member-centered engagement to streamline compliance and accelerate deployment. Purpose-built for the unique complexities of Medicaid, the platform incorporates proprietary data assets and advanced workflow infrastructure developed by HMS to deliver exceptional verification accuracy and operational efficiency.

Designed to operate independently from core eligibility systems, CEV supports rapid implementation—in as little as 90 days—while maintaining full interoperability with existing state applications. This scalable, auditable solution enables states to meet federal mandates with confidence, reduce administrative burden, and safeguard coverage continuity for vulnerable populations.

Key Features

• Member-centered design: Multichannel and proactive outreach via continuous monitoring, helping members stay enrolled
• Independent and agile: Deploys rapidly without modifying existing eligibility infrastructure, but fully integrated with existing state systems and applications
• Fully auditable: Supports transparency and compliance with evolving federal guidance
• Data-first ex parte verification: Automates most exemptions and verifications through precision data matching
• AI and automation: Reduces manual processing and administrative errors
• Connect members with employment opportunities: Guides members to hyper-local job and community engagement opportunities for self-sufficiency and sustained enrollment
• Proven at scale: Built on extensive Medicaid and industry member verification experience across the nation
  

Why It Matters

H.R. 1 requires states to verify that able-bodied adults complete community engagement activities before Medicaid enrollment or renewal. Many states face compressed implementation timelines and growing risks of inaccurate disenrollment. CEV enables faster, lower-cost compliance while supporting equitable access and member engagement.

Gainwell is collaborating with CMS and multiple states to prepare for federal implementation milestones beginning in 2026, helping leaders achieve readiness and confidence ahead of the deadlines.

About Gainwell Technologies
Gainwell Technologies is the trusted leader in digital and cloud-enabled solutions for health and human services programs. With over 50 years of proven expertise, we help modernize Medicaid and public health programs with innovative solutions to improve operational efficiency, enhance provider experiences, while safeguarding program integrity with HMS verification and cost-containment services. Combining cutting-edge technology with an unwavering commitment to service excellence, Gainwell delivers scalable, impactful solutions that advance public health and create transformational results. Learn more at gainwelltechnologies.com.

Gainwell Media Contact
Cecile Fradkin, S&C PR for Gainwell, cfradkin@scprgroup.com.