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Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services (CMS)Interoperability & Standardization - Provider ID (NPPES)

PART ONE


OVERVIEW


1. Date of Submission:
2008-02-04
2. Agency:
009
3. Bureau:
38
4. Name of this Capital Asset:
CMS Interoperability & Standardization - Provider ID (NPPES)
5. Unique Project Identifier:
009-38-01-02-01-3100-00
6. What kind of investment will this be in FY2009?
Operations and Maintenance
7. What was the first budget year this investment was submitted to OMB?
FY2001 or earlier
8. Provide a brief summary and justification for this investment, including a brief description of how this closes in part or in whole an identified agency performance gap.
The National Plan and Provider Enumeration System (NPPES) is the system that enumerates health plans and providers in compliance with the requirements of HIPAA. HIPAA requires the Secretary of Health and Human Services to adopt a national standard identifier for all health plans and providers for use in the health care system. This scope extends to all heath plans and providers not just Medicare and Medicaid. NPPES processes applications from health care providers for National Provider Identifiers (NPIs). NPIs are identification numbers that health care providers are required by regulation to obtain and use to identify themselves in electronic health transactions, such as electronic claims and eligibility inquiries. NPIs do not change and do not expire. NPPES captures, by application, identifying information about health care providers. It processes each application to ensure the uniqueness of the health care provider, and then assigns the health care provider its NPI. NPPES establishes a record for every health care provider it enumerates. NPPES processes updates and changes to the data in an enumerated health care provider's record and deactivates and reactivates a health care provider's NPI upon request by the health care provider. The NPPES makes available, upon approved requests, information about each enumerated health care provider, including the NPI. NPPES assists with reducing the incidence of provider misidentificatio n. It helps to differentiate between fraudulent providers and those who make honest billing mistakes. It allows for easy access to obtain NPIs. Finally, it supports defining, developing, implementing, and maintaining uniform data standards for the exchange of health care information in our programs, as well as across the nation's health care system. This system went into production during FY 2006 with no major planned enhancements. This menas the current solution is still the best alternative solution. NPPES supports HHS & PMA goals such as Expanded E-Government by implementing a web-based application for providers to obtain their NPI, improving system and technology information management, providing efficient business processes, and maintaining data itegrity . This investment will be in the evaluate phase during FY 2007 & 2008.
9. Did the Agency's Executive/Investment Committee approve this request?
yes
9.a. If "yes," what was the date of this approval?
2007-06-26
10. Did the Project Manager review this Exhibit?
yes
11.a. What is the current FAC-P/PM certification level of the project/program manager?
TBD
12. Has the agency developed and/or promoted cost effective, energy-efficient and environmentally sustainable techniques or practices for this project.
no
12.a. Will this investment include electronic assets (including computers)?
yes
12.b. Is this investment for new construction or major retrofit of a Federal building or facility? (answer applicable to non-IT assets only)
no
13. Does this investment directly support one of the PMA initiatives?
yes
If yes, select the initiatives that apply:
Initiative Name
Expanded E-Government
13.a. Briefly and specifically describe for each selected how this asset directly supports the identified initiative(s)? (e.g. If E-Gov is selected, is it an approved shared service provider or the managing partner?)
NPPES supports Expanding E-Government by implementing a web-based application for providers to obtain an NPI. It allows health care providers to submit an electronic application for enumeration & to make updates to data, including deactivations via the web site. It improves systems & technology info. mgmt. for federal, state, & local governments & contractors. By using E-Gov strategies, NPPES provides efficient business processes & helps to maintain data integrity in a cost effective manner.
14. Does this investment support a program assessed using the Program Assessment Rating Tool (PART)?
yes
14.a. If yes, does this investment address a weakness found during the PART review?
yes
14.b. If yes, what is the name of the PARTed program?
2003: CMS - Medicare Program
14.c. If yes, what rating did the PART receive?
Moderately Effective
15. Is this investment for information technology?
yes
16. What is the level of the IT Project (per CIO Council's PM Guidance)?
Level 3
17. What project management qualifications does the Project Manager have? (per CIO Council's PM Guidance)
(1) Project manager has been validated as qualified for this investment
18. Is this investment identified as high risk on the Q4 - FY 2007 agency high risk report (per OMB memorandum M-05-23)?
no
19. Is this a financial management system?
no
20. What is the percentage breakout for the total FY2009 funding request for the following? (This should total 100%)
AreaPercentage
Hardware8
Software13
Services66
Other13
21. If this project produces information dissemination products for the public, are these products published to the Internet in conformance with OMB Memorandum 05-04 and included in your agency inventory, schedules and priorities?
yes
22. Contact information of individual responsible for privacy related questions.
NameMaribel Franey
Phone Number410-786-0757
TitleDirector, Privacy Compliance
EmailMaribel.Franey@cms.hhs.gov
23. Are the records produced by this investment appropriately scheduled with the National Archives and Records Administration's approval?
yes
24. Does this investment directly support one of the GAO High Risk Areas?
yes

SUMMARY OF SPEND


1. Provide the total estimated life-cycle cost for this investment by completing the following table. All amounts represent budget authority in millions, and are rounded to three decimal places. Federal personnel costs should be included only in the row designated Government FTE Cost, and should be excluded from the amounts shown for Planning, Full Acquisition, and Operation/Maintenance. The total estimated annual cost of the investment is the sum of costs for Planning, Full Acquisition, and Operation/Maintenance. For Federal buildings and facilities, life-cycle costs should include long term energy, environmental, decommissioning, and/or restoration costs. The costs associated with the entire life-cycle of the investment should be included in this report.

All amounts represent Budget Authority

Note: For the cross-agency investments, this table should include all funding (both managing partner and partner agencies).

Government FTE Costs should not be included as part of the TOTAL represented.
Cost TypePy-1 & Earlier
-2006
PY
2007
CY
2008
BY
2009
Planning Budgetary Resources0.0000.0000.0000.000
Acquisition Budgetary Resources12.6590.0000.0000.000
Maintenance Budgetary Resources9.0913.7772.0304.111
Government FTE Cost0.1880.1950.1500.159
# of FTEs2222
2. Will this project require the agency to hire additional FTE's?
no
3. If the summary of spending has changed from the FY2008 President's budget request, briefly explain those changes.
N/A

PERFORMANCE


In order to successfully address this area of the exhibit 300, performance goals must be provided for the agency and be linked to the annual performance plan. The investment must discuss the agency's mission and strategic goals, and performance measures (indicators) must be provided. These goals need to map to the gap in the agency's strategic goals and objectives this investment is designed to fill. They are the internal and external performance benefits this investment is expected to deliver to the agency (e.g., improve efficiency by 60 percent, increase citizen participation by 300 percent a year to achieve an overall citizen participation rate of 75 percent by FY 2xxx, etc.). The goals must be clearly measurable investment outcomes, and if applicable, investment outputs. They do not include the completion date of the module, milestones, or investment, or general goals, such as, significant, better, improved that do not have a quantitative measure.
Agencies must use the following table to report performance goals and measures for the major investment and use the Federal Enterprise Architecture (FEA) Performance Reference Model (PRM). Map all Measurement Indicators to the corresponding Measurement Area and Measurement Grouping identified in the PRM. There should be at least one Measurement Indicator for each of the four different Measurement Areas (for each fiscal year). The PRM is available at www.egov.gov. The table can be extended to include performance measures for years beyond FY 2009.
RowFiscal YearStrategic Goal SupportedMeasurement AreaMeasurement GroupingMeasurement IndicatorBaselinePlanned Improvement to the BaselineActual Results
12006S.O. 1.1 - Broaden health insurance and long-term care coverageMission and Business ResultsHealth Care AdministrationPercentage of existing health care providers receiving an NPI0100%91%
22006S.O. 1.1 - Broaden health insurance and long-term care coverageTechnologyAvailabilityPercentage of system availability95%98%93%
32006Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days to process a clean web application751
42006S.O. 1.1 - Broaden health insurance and long-term care coverageProcesses and ActivitiesErrorsPercent of web cases that require manual intervention20%15%30
52007S.O. 1.1 - Broaden health insurance and long-term care coverageMission and Business ResultsHealth Care AdministrationPercentage of existing health care providers receiving an NPI100100TBD
62007S.O. 1.1 - Broaden health insurance and long-term care coverageTechnologyAvailabilityPercentage of system availability93%93%TBD
72007Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days to process a clean web application55TBD
82007S.O. 1.1 - Broaden health insurance and long-term care coverageProcesses and ActivitiesErrorsPercent of web cases that require manual intervention30%30%TBD
92008S.O. 1.1 - Broaden health insurance and long-term care coverageMission and Business ResultsHealth Care AdministrationPercentage of new applicants receiving an NPI100%100%TBD
102008S.O. 1.1 - Broaden health insurance and long-term care coverageTechnologyAvailabilityPercentage of system availability93%93%TBD
112008Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days to process a clean web application55TBD
122008S.O. 1.1 - Broaden health insurance and long-term care coverageProcesses and ActivitiesErrorsPercent of web cases that require manual intervention30%30%TBD
132009S.O. 1.1 - Broaden health insurance and long-term care coverageMission and Business ResultsHealth Care AdministrationPercentage of new applicants receiving an NPI100%100%TBD
142009S.O. 1.1 - Broaden health insurance and long-term care coverageTechnologyAvailabilityPercentage of system availability93%93%TBD
152009Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days to process a clean web application55TBD
162009S.O. 1.1 - Broaden health insurance and long-term care coverageProcesses and ActivitiesErrorsPercent of web cases that require manual intervention30%30%TBD
172010S.O. 1.1 - Broaden health insurance and long-term care coverageMission and Business ResultsHealth Care AdministrationPercentage of new applicants receiving an NPI100%100%TBD
182010S.O. 1.1 - Broaden health insurance and long-term care coverageTechnologyAvailabilityPercentage of system availability93%93%TBD
192010Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days to process a clean web application55TBD
202010Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of web cases that require manual intervention30%30%TBD
212007Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days for Enumerator to process a clean paper application2020TBD
222007Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of day for Enumerator to process un-clean paper applications3030TBD
232008Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days for Enumerator to process a clean paper application2020TBD
242008Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of day for Enumerator to process un-clean paper applications3030TBD
252009Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days for Enumerator to process a clean paper application2020TBD
262009Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of day for Enumerator to process un-clean paper applications3030TBD
272010Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of days for Enumerator to process a clean paper application2020TBD
282010Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsResponse TimeNumber of day for Enumerator to process un-clean paper applications3030TBD
292007Effective Management of Human Capital/Information Technology/ResourcesMission and Business ResultsHealth Care AdministrationPercent of NPPES data available for Data Dissemination100%100%TBD
302008Effective Management of Human Capital/Information Technology/ResourcesMission and Business ResultsHealth Care AdministrationPercent of NPPES data available for Data DisseminationTBD100%TBD
312009Effective Management of Human Capital/Information Technology/ResourcesMission and Business ResultsHealth Care AdministrationPercent of NPPES data available for Data DisseminationTBD100%TBD
322010Effective Management of Human Capital/Information Technology/ResourcesMission and Business ResultsHealth Care AdministrationPercent of NPPES data available for Data DisseminationTBD100%TBD

Enterprise Architecture


In order to successfully address this area of the business case and capital asset plan you must ensure the investment is included in the agency's EA and Capital Planning and Investment Control (CPIC) process, and is mapped to and supports the FEA. You must also ensure the business case demonstrates the relationship between the investment and the business, performance, data, services, application, and technology layers of the agency's EA.
1. Is this investment included in your agency's target enterprise architecture?
yes
2. Is this investment included in the agency's EA Transition Strategy?
yes
2.a. If yes, provide the investment name as identified in the Transition Strategy provided in the agency's most recent annual EA Assessment.
CMS Interoperability and Standardization - Provider Identification
3. Is this investment identified in a completed (contains a target architecture) and approved segment architecture?
no
4. Identify the service components funded by this major IT investment (e.g., knowledge management, content management, customer relationship management, etc.). Provide this information in the format of the following table. For detailed guidance regarding components, please refer to http://www.whitehouse.gov/omb/egov/.

Component: Use existing SRM Components or identify as NEW. A NEW component is one not already identified as a service component in the FEA SRM.

Reused Name and UPI: A reused component is one being funded by another investment, but being used by this investment. Rather than answer yes or no, identify the reused service component funded by the other investment and identify the other investment using the Unique Project Identifier (UPI) code from the OMB Ex 300 or Ex 53 submission.

Internal or External Reuse?: Internal reuse is within an agency. For example, one agency within a department is reusing a service component provided by another agency within the same department. External reuse is one agency within a department reusing a service component provided by another agency in another department. A good example of this is an E-Gov initiative service being reused by multiple organizations across the federal government.

Funding Percentage: Please provide the percentage of the BY requested funding amount used for each service component listed in the table. If external, provide the funding level transferred to another agency to pay for the service.
RowAgency Component NameAgency Component DescriptionService TypeComponentReused Component NameReused UPIInternal or External Reuse?Funding %
1Standardized / CannedDefines the set of capabilities that support the use of pre-conceived or pre-written reports.ReportingStandardized / Canned  No Reuse50
2Data ExchangeDefines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered.Data ManagementData Exchange  No Reuse50
5. To demonstrate how this major IT investment aligns with the FEA Technical Reference Model (TRM), please list the Service Areas, Categories, Standards, and Service Specifications supporting this IT investment.

FEA SRM Component: Service Components identified in the previous question should be entered in this column. Please enter multiple rows for FEA SRM Components supported by multiple TRM Service Specifications.

Service Specification: In the Service Specification field, Agencies should provide information on the specified technical standard or vendor product mapped to the FEA TRM Service Standard, including model or version numbers, as appropriate.
RowSRM Component>Service AreaService CategoryService StandardService Specification (i.e., vendor and product name)
1Data ExchangeComponent FrameworkData InterchangeData ExchangeConnect:Direct
2Data ExchangeService Interface and IntegrationIntegrationEnterprise Application IntegrationConnect:Direct
3Data ExchangeService Access and DeliveryDelivery ChannelsExtranetIBM HTTP Server 5.1
4Data ExchangeComponent FrameworkData InterchangeData ExchangeSOAP
5Standardized / CannedComponent FrameworkData ManagementReporting and AnalysisTBD
6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?
yes
6.a. If yes, please describe.
This investment leverages: Federal Health Architecture (FHA)

PART THREE


RISK


You should perform a risk assessment during the early planning and initial concept phase of the investment's life-cycle, develop a risk-adjusted life-cycle cost estimate and a plan to eliminate, mitigate or manage risk, and be actively managing risk throughout the investment's life-cycle.

Answer the following questions to describe how you are managing investment risks.
1. Does the investment have a Risk Management Plan?
yes
1.a. If yes, what is the date of the plan?
2007-07-31
1.b. Has the Risk Management Plan been significantly changed since last year's submission to OMB?
no

COST & SCHEDULE


1. Was operational analysis conducted?
yes
1.a. If yes, provide the date the analysis was completed.
2007-09-10
What were the results of your operational analysis?
This investment still meets the needs of its stakeholders and users. An operational analysis was performed and the project is within the 10 percent cost and schedule variance. We are on target to meet the milestones per the approved baseline. The system is being implemented to meet the CMS' requirements and needs.