MPVaaS by Infocap

Medicaid Pre-Verification-as-a-Service

State Medicaid agencies are under unprecedented pressure to modernize eligibility operations while managing rising caseloads, tighter compliance requirements, and new federal and state mandates like H.R.1 work requirements, community engagement, and education or job training tracking. Manual processes, fragmented data sources, and aging MMIS platforms are turning eligibility verification into a bottleneck, a compliance risk, and a major drain on staff time. We have a solution for that.

Real-Time Eligibility Verification for Modern Medicaid Programs

Medicaid Pre-Verification-as-a-Service (MPVaaS) by Infocap is a cloud-native, serverless platform purpose-built to solve this problem.

MPVaaS enables state Medicaid agencies to verify applicant eligibility in real time or in batch using direct Federal Data Services Hub (FDSH) integration, automated income and employment verification, and support for work requirement compliance, all while maintaining a complete, tamper-proof audit trail for state and federal oversight.

The result: faster determinations, dramatically lower manual workload, and audit-ready compliance by design.

 

The Challenge States Are Facing

Even before new work requirements, many states were already struggling with eligibility backlogs and manual verification workflows. Now:

  • Verification workload has effectively doubled, with new criteria that must be checked multiple times per year.
  • Reliable data sources for workforce participation are fragmented or incomplete, forcing caseworkers to rely on manual attestations and document reviews, driving improper payment risk.
  • Compliance deadlines are looming, but modernizing or replacing MMIS platforms typically takes 12–24 months and tens or hundreds of millions of dollars.
  • Manual document handling and verification consumes enormous staff time and creates audit exposure.

States need a way to modernize now, without waiting years for a full system replacement.

The Infocap Approach

MPVaaS is not a retrofitted enterprise product. It is government-first, compliance-first, and built specifically for Medicaid.

It acts as an intelligent verification layer that:

  • Integrates directly with FDSH, state, and commercial data sources
  • Applies state-specific eligibility rules
  • Orchestrates verification workflows automatically
  • Produces a complete, tamper-proof audit trail
  • Integrates cleanly with existing MMIS and eligibility systems

All delivered as a secure, serverless platform that can be deployed in months, not years, scaling from the smallest Medicaid pool of covered lives, to the largest.

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What is MPVaaS?

Medicaid Pre-Verification-as-a-Service (MPVaaS) is a cloud-native, serverless platform built on AWS that enables:

  • Real-time and batch eligibility verification
  • Automated income, employment, and work requirement checks
  • State-specific rules execution
  • End-to-end audit documentation

The platform is designed to reduce manual processing time by 80–90% while delivering near real-time determinations with audit-ready compliance.

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Core Capabilities

Real-time and batch data integration

Real-time and batch data integration

Direct integration with the Federal Data Services Hub (FDSH), as well as state and commercial data sources, to verify income, employment, and eligibility criteria on a per-state basis.

H.R.1 work requirement compliance

H.R.1 work requirement compliance

Automation-enhanced verification of:

  • Work hours
  • Schooling or training
  • Community engagement or volunteering activities

Reducing reliance on manual attestations and document reviews.

State-specific rules engine

State-specific rules engine

A configurable rules engine that supports each state’s unique Medicaid eligibility policies without hardcoding or brittle custom development.

Automated audit trail

Automated audit trail

Every decision, data source, and rule evaluation is logged in a tamper-proof audit trail, supporting both state and federal audits by design.

Serverless, cloud-native architecture

Serverless, cloud-native architecture

Built on AWS Lambda, MPVaaS delivers:

  • 10x cost efficiency vs. traditional on-prem systems
  • Automatic scaling for peak enrollment periods
  • High availability without infrastructure overhead

Why Infocap is Different

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Built for Government, Not Retrofitted

MPVaaS is designed specifically for Medicaid compliance and operations, not adapted from commercial insurance or enterprise workflow tools.

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Deep CMS and Medicaid Expertise

Infocap brings 10+ years of CMS and eligibility systems experience, including:

  • CFR and federal policy alignment
  • State-specific program requirements
  • Federal and state data integration patterns
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Proven Serverless Architecture

Infocap is AWS Lambda Service Delivery Designation (SDD) certified (certification expected Q1 2026), validating:

  • Architectural rigor
  • Cost optimization
  • Serverless best practices
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Real-World Validation

  • FDSH, state, and commercial integrations validated with three state Medicaid systems
  • Deployment model: 3–6 months vs. 12–24 months for legacy systems and traditional systems integrators

How it Fits into Your Existing Environment

MPVaaS is designed to complement, not replace, your MMIS or eligibility platform.

It uses:

  • Amazon API Gateway for secure FDSH and system integrations
  • AWS Bedrock / Bedrock Data Automation for document ingestion and extraction
  • AWS Step Functions for workflow orchestration
  • Amazon EventBridge for event-driven automation
  • Amazon S3 for secure document storage
  • Amazon RDS (PostgreSQL) for the state rules engine

This allows MPVaaS to act as a modern verification and compliance layer around your existing core systems.

 

Outcomes for State Medicaid Agencies

Dramatically faster processing

  • 80–90% reduction in eligibility verification time
  • From 5–10 business days down to 2–4 hours

Audit-ready compliance

  • 100% audit traceability with automated, tamper-proof documentation
  • Reduced improper payment risk and compliance exposure

Faster time to value

  • 3–6 month deployment 12–24 months for MMIS replacement or major modernization programs

Staff productivity and morale

  • Caseworkers spend less time chasing documents
  • More time focused on serving beneficiaries and resolving exceptions

 

Who This is For

MPVaaS is designed for U.S. State Medicaid Agencies, especially those:

  • In active modernization cycles (35+ states today)
  • Facing H.R.1 work requirement implementation
  • Experiencing eligibility backlogs or audit pressure
  • Looking for a faster, lower-risk modernization path

 

A Smarter Path to Medicaid Modernization

You don’t have to wait years, or risk a massive core system replacement, to fix eligibility verification.

MPVaaS delivers immediate, measurable impact while fitting into your existing architecture and long-term modernization roadmap.

Let's Talk 💬

If your agency is facing eligibility backlogs, work requirement compliance challenges, or audit pressure, Infocap can help.

Contact us to learn how MPVaaS can modernize eligibility verification in months, not years, and reduce risk while improving service to citizens.

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