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Spec: specs/pf/specs/PF-96-medicaid-state-compliance-configuration.md
Owner: PF (Platform Foundation)
Created: 2026-03-29
Integration Overview
PF-96 provides the jurisdiction profile system — a multi-tier configuration layer that decouples state-specific Medicaid compliance rules from hardcoded constants. It is consumed by CL, PM, and PF features via a resolution function and frontend hook.
Location: src/platform/jurisdiction/
Public API:
| Export | Type | Purpose |
|---|
useJurisdictionProfile(siteId?) | React hook | Resolve effective profile for current org + optional site |
useClinicalRules(siteId?) | React hook | Convenience accessor for clinical rule pack |
useBillingRules(siteId?) | React hook | Convenience accessor for billing rule pack |
useComplianceRules(siteId?) | React hook | Convenience accessor for compliance rule pack |
JurisdictionProfile | TypeScript interface | Resolved profile shape |
ClinicalRules | TypeScript interface | Clinical rule pack |
BillingRules | TypeScript interface | Billing rule pack |
ComplianceRules | TypeScript interface | Compliance rule pack |
| Export | Location | Purpose |
|---|
getJurisdictionProfile(client, orgId, siteId?) | supabase/functions/_shared/jurisdiction.ts | Server-side profile resolution |
Event Contracts
Events Published
pf_jurisdiction_profile_changed
-
Publisher: PF-96 (on org/site jurisdiction config change)
-
Subscribers: CL-02, CL-04, CL-40, PM-07, PM-08, PM-41, PF-91
-
Payload Schema:
{
event_id: string; // UUID - unique event identifier for deduplication
organization_id: string; // UUID
site_id?: string; // UUID, present if site-level change
old_profile_code: string; // e.g. "az-ahcccs"
new_profile_code: string; // e.g. "ca-medi-cal"
changed_by: string; // UUID of user who made the change
}
-
Status: ✅ Complete
Events Consumed
| Event | Source | Purpose |
|---|
pf_organization_created | PF-01 | Set default federal baseline jurisdiction profile on new org |
pf_site_created | PF-19 | Prompt for jurisdiction profile if org is multi-state |
API Contracts
RPC Functions
pf_resolve_jurisdiction_profile(p_org_id UUID, p_site_id UUID DEFAULT NULL)
- Type: PostgreSQL RPC (SECURITY DEFINER)
- Returns:
JSONB — Merged profile with { profile_id, state_code, program_code, display_name, clinical, billing, compliance }
- Consumers: All CL/PM features, PF-91 compliance dashboard, edge functions
- Resolution Order: Federal baseline → State profile → Org overrides → Site overrides
- Status: ✅ Complete
Consumer Integration Points
| Consumer Spec | What It Reads | How It Integrates |
|---|
| CL-02 (Assessments) | clinical.assessment_required_elements, clinical.assessment_completion_hours | useClinicalRules() hook |
| CL-04 (Progress Notes) | clinical.documentation_timeliness_hours, clinical.required_note_elements | useClinicalRules() hook |
| CL-11 (Consent) | clinical.minor_consent_age, clinical.sud_confidentiality_standard | useClinicalRules() hook |
| CL-40 (Intake) | clinical.intake_assessment_type | useClinicalRules() hook / edge function helper |
| PM-07 (Charge Capture) | billing.min_billable_minutes, billing.modifier_conventions | useBillingRules() hook |
| PM-08 (Claims) | billing.filing_deadline_days | useBillingRules() hook |
| PM-10 (Prior Auth) | billing.bhrf_urgent_pa_exempt_days | useBillingRules() hook |
| PM-18 (Scrub Rules) | billing.modifier_conventions | getJurisdictionProfile() edge fn |
| PM-41 (Compliance Reports) | billing.compliance_window_hours | getJurisdictionProfile() edge fn |
| PF-91 (Compliance Dashboard) | All rule packs | useJurisdictionProfile() hook |
Security
- RLS: All three tables have RLS + FORCE enabled
- Profile access: All authenticated users can read active profiles (shared reference data)
- Config access: Org-scoped via
pf_has_org_access(); admin writes via pf_has_org_role()
- Federal baseline enforcement:
pf_validate_jurisdiction_override() trigger prevents weakening federal requirements
- No PHI: Profiles contain configuration data only; no patient data
References
