CMS Pub. 100-15, ch. 2, § 2.1.4

a. Purpose of the JOA

The UPICs’ activities are governed by CMS’ Task Order Statement of

Work (TO SOW), the Medicaid PIM, and the Medicare PIM. However,

the SMA is not governed by the PIM. The JOA is an agreement between

the SMA and the UPIC that establishes guidelines, duties, and shared

expectations of how each will conduct business with the other. The JOA

will include any agreement between the SMA and the UPIC on program

implementation and operation that is not specified in this manual or the

TO SOW. CMS also has a role in mediating any disputes that may arise

between the SMA and the UPIC during the creation of the JOA, and it will

provide technical guidance regarding the JOA.

The template for the JOA can be found at Appendix J..

b. JOA Template and Instructions for Customizing the JOA

The UPIC shall customize the JOA template with input from the SMA.

The template is a guide and includes suggested language, which may be

changed pending the agreement of the UPIC and the SMA. SMAs are

encouraged to participate in other implementation activities while awaiting

the review and execution of the JOA. However, it is at the discretion of

the SMA whether to participate in other implementation activities while

awaiting the JOA. It is a best practice for the SMA to sign the JOA as

soon as possible as the JOA clarifies the working relationship between the

SMA and the UPIC.

The following provides a summary for each section of the JOA:

Section 1. Introduction

This section describes the purpose of the coordination and the JOA. It also

describes how the JOA should be maintained and updated.

Section 2. Implementation

This section describes the overall implementation process and each party’s

responsibilities.

Section 3. Dispute Resolution

This section describes how disagreements between the UPIC and the SMA

will be resolved. It is recommended that disagreements be brought to the

attention of the COR/BFL team for assistance.

Section 4. Communications Plan

This section outlines the requirements for establishing points of contact at

the UPIC and SMA, regular meetings, and work groups. The UPIC and

the SMA should establish points of contact to clarify communications

between organizations. The JOA template suggests the creation of “leads”

in the areas of the overall project, IT, data analysis, and investigations.

The UPIC and SMA, as applicable, should revise and add to these roles as

appropriate.

Section 5. Training and Information Sharing

In this section, the UPIC and the SMA acknowledge that each party will

provide training to the other party and share information with each other

as needed. The way in which training shall be provided should also be

described in this section.

Section 6. Connectivity and Data Sharing, if applicable

This section outlines how the UPIC and the SMA will work together to

share the necessary data. Due to the nature of this content, section 6.5

Security shall not be edited and/or revised by either the SMA or the UPIC.

Section 7. Data Analysis

This section describes the development of a Data Analysis Project

Management Strategy and the process for prioritizing projects and sharing

results.

Section 8. Investigations and Referrals

This section describes the investigation and referral processes for joint

investigations. The JOA clarifies the rules outside of the PIM to which the

UPIC and the SMA must adhere. It provides a forum through which the

partners can agree on how to work together on joint investigations.

c. Process for Executing the Initial JOA

The UPIC and the SMA shall discuss the timeline and contents of the JOA

during the Initial State Collaboration Meeting. Based on the results of this

meeting, the UPIC shall customize the JOA template (Appendix J)

collaboratively with the SMA and submit to CMS for approval. CMS will

provide technical assistance on the customization as needed. If, after

reasonable efforts by the UPIC, there are issues that the SMA and the

UPIC cannot agree upon, either of the parties may notify CMS. CMS will

coordinate resolutions of the disputes so that the implementation process is

not delayed.

The UPIC and the SMA should agree to the content of the JOA, as it

details how the partners will work together. The JOA is not a contract.

Therefore, the SMA is not required to provide signatures for the JOA. In

place of signing the JOA, the SMA can inform the UPIC through an e-

mail or formal letter that the JOA accurately reflects how the parties will

work together to implement and operate the coordinated efforts.

The UPIC shall distribute a copy of the final JOA to the SMA. The SMA

lead should disseminate the final JOA within the agency.

d. Annual Review of the JOA

The UPIC and the SMA should review and revise the JOA at least

annually. The revised JOA should be approved by the UPIC and the

SMA and be submitted to CMS by the UPIC.

e. Other Revisions to the JOA

The UPIC and the SMA may revise the JOA on an as-needed basis, as

long as the changes are agreed upon by both parties in accordance with a

process that both parties establish during implementation.