pro·ve·nance — the documented origin and chain of custody of a record
Every number you report to CMS came from somewhere.
I can tell you where.
Medicaid enterprise systems weren't built to talk to each other. The gaps between them are where federal liability accumulates — silently, for years, until someone else finds it.
One member. Four systems. Three agreements and a break.
Illustrative trace.
Real engagements run this across the full population.
Eligibility
MEMBER 4471‑09
✓ present
MMIS / claims
MEMBER 4471‑09
✓ reconciles
Encounter
MEMBER 4471‑09
✓ reconciles
Federal report
NOT PRESENT
✕ break — exposure
The record was real at every step but the last one. Nothing in your dashboards is wrong — the disagreement only exists between the systems.
Multiply by a population and a transition window. That is the number someone else eventually finds.
Record
$115M
Federal liability
Resolved after the agency's IT division determined the required reporting was technically impossible.
federal reporting ↔ MMIS · under CMS and legislative oversight
~45,000
Members
Incorrectly enrolled during an MMIS vendor transition. Surfaced through cross-system analysis before it became an audit finding.
eligibility ↔ new MMIS · during cutover
9 years
Inside
Inside a state Medicaid agency, under both legislative and CMS oversight.
not a vendor · the person who had to answer for the number
The engagement
Transition & Reporting Integrity Diagnostic
An independent reconciliation of eligibility, claims, and federal reporting extracts against each other — producing a quantified list of where the systems disagree and what that exposure is worth.
Fixed fee
No hourly drift
6 weeks
Calendar, start to briefing
One analyst
Me. No bench, no handoff
Findings memo
Each discrepancy, its root cause, its estimated federal exposure — ranked by dollar magnitude.
Documented reconciliation logic
The queries and match rules, so your team can re-run it quarterly without me.
Remediation roadmap
What to fix, in what order, who owns it.
One executive briefing
Sixty minutes, CFO and CIO level.
How it runs
Four weeks of work across six weeks of calendar
WEEK 1
Scope & extracts
Agree the population, periods, and files. Data-use terms signed before anything moves.
WEEK 2–3
Cross-system reconciliation
Eligibility, claims, encounter, and federal reporting matched against one another, record by record.
WEEK 4
Root cause & exposure
Each break traced to its cause and priced. Ranked by dollars, not by count.
WEEK 5
Draft review
Your team challenges the logic before anything is final. Nothing lands as a surprise.
WEEK 6
Memo & briefing
Findings, logic, and roadmap delivered. Sixty minutes with the executives who own it.
Jeff Grabinski
Principal
Who you'd be working with
I spent nine years inside a state Medicaid agency, answering to legislative auditors and CMS for numbers I did not generate.
The pattern was always the same: every system was internally correct, every report was produced on schedule, and the exposure lived in the space between them — unowned, unreconciled, and growing. Twice I found it before someone else did. That is the work I do now, on a fixed fee, for agencies and plans who would rather know first.
Eligibility & enrollment mismatches
Encounter data gaps
Incomplete provider records
Send me one reporting period.
I'll tell you where it disagrees with itself. Thirty minutes, no deck, no discovery call disguised as a sales call.