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Executive PERM Risk-Acceptance Template

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Aug 27, 2026

Executive PERM Risk-Acceptance Template

A two-page governance template for Medicaid leaders documenting material eligibility-control changes, fiscal exposure, compensating controls, and explicit residual-risk decisions.

Ralph Choate
Ralph Choate
PERM Finding Response Path

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Aug 27, 2026

PERM Finding Response Path

A two-page operational guide for state Medicaid leaders moving potential PERM findings from rapid factual review through resolution, corrective action, and verified closure.

Ralph Choate
Ralph Choate
Eligibility Decision Evidence Standard

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Aug 27, 2026

Eligibility Decision Evidence Standard

A two-page minimum audit-trail standard for Medicaid leaders strengthening eligibility evidence, decision reconstruction, and audit defensibility.

Ralph Choate
Ralph Choate
Shadow PERM Implementation Guide

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Aug 27, 2026

Shadow PERM Implementation Guide

A four-page operational framework for state Medicaid leaders using internal eligibility sampling to identify accuracy, audit-defensibility, and control failures before federal selection.

Ralph Choate
Ralph Choate
PERM Pre-Cycle Readiness Matrix

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Aug 26, 2026

PERM Pre-Cycle Readiness Matrix

A two-page operational assessment for state Medicaid leaders testing policy, system, operational, and stakeholder readiness before the next PERM cycle.

Ralph Choate
Ralph Choate

PERM Insights & Perspectives

Independent analysis of Medicaid policy, eligibility accuracy, accountability, operational risk, and fiscal exposure.

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