Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services CMS Interoperabilty & Standardization - Provider Enrollment (PECOS)

1. Date of Submission:

2008-02-04

2. Agency:

009

3. Bureau:

38

4. Name of this Capital Asset:

CMS Interoperability & Standardization - Provider Enrollment (PECOS)

5. Unique Project Identifier:

009-38-01-02-01-1115-00

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?

FY2008

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.

This investment funds the PECOS, which is a national repository of all Medicare provider and supplier (p/s) enrollment data. PECOS standardizes the enrollment process used by Medicare Contractors (MC). PECOS retains all information submitted by p/s and only requires updates to the initial enrollment data. Information is available nationally. The need for p/s practicing in multiple states or billing multiple MC to completely reenroll is eliminated. PECOS makes updating existing information easier, eliminates duplicate data entry and provides uniform data to the FFS claims systems. PECOS enables MC reviewing enrollment applications to determine if an applicant was previously enrolled in Medicare through another contractor and to identify all of the applicant's affiliations with other Medicare enrolled providers. PECOS improves the accuracy of enrollment data and ensures that only qualified p/s are enrolled with Medicare. PECOS greatly reduces the amount of time needed to process provider enrollment applications. By offering a more complete picture of p/s business operations, PECOS helps to ensure Medicare works only with reputable business partners. As a national enrollment database, PECOS significantly enhances fraud and abuse prevention and enforcement activities since it allows CMS and enrollment MC to view all Medicare activity of a particular p/s. Fraud investigators have a complete national picture of a provider and its managers and owners, allowing them to check for patterns of fraud that cross providers and/or contractor jurisdictions. PECOS also identifies p/s who have been denied privileges, or are subject to revocations or exclusions. PMA: (1) Human Capital: PECOS is a citizen centric business model. P/S are able to manage their own enrollment activities with less dependency on Medicare Contractors. MC spend less time per enrollment activity. (2)Expanded E- Government: PECOS deploys an electronic tool for the p/s community to manage their Medicare enrollment information and reduces the reporting burden on the p/s community. Additionally, the tool reduces errors and ensures completeness of data. (3) Improved Financial Performance: PECOS reduces operational processing costs, increases auto-adjudication rates, and assists CMS in its efforts to reduce fraud and abuse. (4) Eliminate Improper Payment: PECOS improves accuracy of p/s enrollment data that is passed to the FFS claims service and used in the payment process.

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
Eliminating Improper Payments
Expanded E-Government
Financial Performance

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?)

PECOS supports financial performance by reducing CMS' financial burden on third party administrators in receiving/keying paper-based provider enrollment forms, responding to customer inquiries & manual support for revalidation efforts. It supports expanded E-Gov because PECOS collects Part A, Part B, & DME enrollment data and feeds the data into the appropriate Medicare FFS claims processing system, eliminating the need for a provider to access multiple systems.

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%)

Area	Percentage
Hardware	0
Software	98
Services	2
Other	0

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?

no

22. Contact information of individual responsible for privacy related questions.

Name	Maribel Franey
Phone Number	410-786-0757
Title	Director, Privacy Compliance
Email	Maribel.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

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 Type	Py-1 & Earlier -2006	PY 2007	CY 2008	BY 2009
Planning Budgetary Resources	0.000	0.000	0.000	0.000
Acquisition Budgetary Resources	6.950	0.000	0.000	0.000
Maintenance Budgetary Resources	17.208	8.888	6.090	12.742
Government FTE Cost	2.000	0.340	0.300	0.371
# of FTEs	6	4	4	4

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.

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.

Row	Fiscal Year	Strategic Goal Supported	Measurement Area	Measurement Grouping	Measurement Indicator	Baseline	Planned Improvement to the Baseline	Actual Results
1	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider enrollment data housed in PECOS	30%	60%	60%
2	2006	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	90%	95%	99
3	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	76%
4	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	95%	97.76%
5	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	60%	70%	TBD
6	2007	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	95%	95%	TBD
7	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
8	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	95%	TBD
9	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider enrollment data housed in PECOS	79%	80%	TBD
10	2008	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	95%	96%	TBD
11	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
12	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	96%	TBD
13	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider enrollment data housed in PECOS	80%	90%	TBD
14	2009	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	96%	97%	TBD
15	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
16	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	96%	97%	TBD
17	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	90%	99%	TBD
18	2010	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	97%	98%	TBD
19	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
20	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	97%	98%	TBD
21	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
22	2011	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	98%	98.5%
23	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
24	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percentage of successful Claims Export availability	98%	98.5%
25	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
26	2012	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	98.5%	99%
27	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
28	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percentage of successful Claims Export availability	98.5%	99%
29	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
30	2013	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	99%	99%
31	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initail enrollment applications processed within 60 days	80%	80%
32	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percentage of successful Claims Exprot availability	99%	99%

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 Health Insurance Portability and Accountability Act (HIPAA). In order to provide HHS more detail and insight into our investments, last year's major initiative was split out into a separate investment.

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.

Row	Agency Component Name	Agency Component Description	Service Type	Component	Reused Component Name	Reused UPI	Internal or External Reuse?	Funding %
1	Access Control	Access Control - Support the management of permissions for logging onto a computer, application, service, or network; includes user management and role/privilege management.	Security Management	Access Control			No Reuse	1
2	Data Warehouse	Defines the set of capabilities that support the archiving and storage of large volumes of data.	Data Management	Data Warehouse			No Reuse	96
3	Data Classification	Defines the set of capabilities that allow the classification of data.	Data Management	Data Classification			No Reuse	1
4	Loading and Archiving	Defines the set of capabilities that support the population of a data source with external data.	Data Management	Loading and Archiving			No Reuse	1
5	Data Exchange	Defines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered.	Data Management	Data Exchange			No Reuse	1

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.

Row	SRM Component	>Service Area	Service Category	Service Standard	Service Specification (i.e., vendor and product name)
1	Access Control	Component Framework	Data Interchange	Data Exchange	Connect Direct
2	Data Exchange	Component Framework	Data Interchange	Data Exchange	Connect:Direct
3	Data Exchange	Service Interface and Integration	Integration	Enterprise Application Integration	Connect:Direct
4	Data Classification	Component Framework	Data Management	Reporting and Analysis	Crystal Reports
5	Loading and Archiving	Service Interface and Integration	Integration	Middleware	DB2 Connector
6	Data Warehouse	Service Platform and Infrastructure	Database / Storage	Database	IBM DB2
7	Loading and Archiving	Service Interface and Integration	Integration	Middleware	Sybase

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)

1. Does the investment have a Risk Management Plan?

yes

1.a. If yes, what is the date of the plan?

2007-08-21

1.b. Has the Risk Management Plan been significantly changed since last year's submission to OMB?

no

1. Was operational analysis conducted?

yes

1.a. If yes, provide the date the analysis was completed.

2007-06-30

What were the results of your operational analysis?

Based on the operational analysis, 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.