Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services, CMS Beneficiary Enrollment and Plan Payment for Part C & D

1. Date of Submission:

2008-02-04

2. Agency:

009

3. Bureau:

38

4. Name of this Capital Asset:

CMS Beneficiary Enrollment and Plan Payment for Part C & D

5. Unique Project Identifier:

009-38-01-02-01-1090-00

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?

FY2007

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 systems that are the cornerstone to providing the Part C and Part D benefit, enabling CMS to support its business and strategic goals (high-value health care and accurate and predictable payments). Due to the compressed time schedule and the complexity of the business requirements for the legislatively required program implementation, systems were brought live to achieve the minimal necessary business functionality. Now, the emphasis moves toward continuing to update business rules and increase the efficiency of the systems. Due to the compressed time schedule and the complexity of the business requirements, this investment leveraged existing processes and modules of existing systems, databases, and applications through modifications and integration for rapid deployment. The Medicare Advantage Prescription Drug System (MARx) and Risk Adjustment System (RAS) process transactions for over 24 Million enrollees from over 704 plans (in 2005 there were 5.8 Million enrollees and more than 300 plans). These numbers are expected to increase due to the rise in eligible beneficiaries and the interest of additional plans to join the program. MARx supports ongoing business processes with business rule updates, functionality enhancements, as well as capacity to support Part D: calculating beneficiary-level payments and risk-adjusted payments; verifying beneficiary eligibility benefits; and processing notifications of beneficiary enrollment. RAS must compute risk factors for all beneficiaries that are used by MARx to compute Part C & D payments. Also included is the Premium Withholding System (PWS) to support a beneficiary election for premium withhold during enrollment. PWS calculates and makes proper adjustments for each beneficiary, processes premiums, and generates daily enrollment files. If this investment was not funded, the agency would not be able to fulfill its mission of delivering prescription drug coverage to Medicare beneficiaries. This investment directly supports the PMA Initiative "Expanded E-Gov" and "Eliminating Improper Payments". This investment directly supports the HHS Strategic Goal cited in Section D, Performance Information. The analysis of the Operational Steady State portion of the investment indicates a growing satisfaction with the results of the survey; this indicated a closing of the gap of needed functionality associated with providing benefits and medical services to the growing Medicare population.

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?

Senior/Expert-level

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
Budget Performance Integration
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?)

Expanded electronic government is supported by using web-based communication, data transfer, and various e-business technologies. This provides a single point of access for CMS information, services, and products enabling robust collaboration between CMS and its business partners. Eliminating Improper Payments is supported by strengthening the payment validation and authorization toolset used to confirm Plan payments.

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)?

yes

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	1
Services	99
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?

n/a

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	69.407	0.000	0.000	0.000
Maintenance Budgetary Resources	27.325	83.294	60.708	87.362
Government FTE Cost	0.810	0.420	1.500	1.530
# of FTEs	4	2	15	15

2. Will this project require the agency to hire additional FTE's?

no

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	2005	S.O. 1.2 - Increase health care service availability and accessibility	Processes and Activities	Efficiency	Percent of identified business functions automated	80%	80%	80%
2	2005	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	New Customers and Market Penetration	Percentage of enrollees (those enrolled compared to those eligible	95%	95%	95%
3	2005	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	85%	90%	90%
4	2005	S.O. 1.1 - Broaden health insurance and long-term care coverage	Mission and Business Results	Health Care Administration	Percentage of legislative requirements met	80%	85%	85%
5	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Efficiency	Accuracy of plan-level payments	80%	85%	85%
6	2006	S.O. 1.1 - Broaden health insurance and long-term care coverage	Mission and Business Results	Health Care Administration	Percentage of legislative requirements met	85%	90%	90%
7	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	90%	90%	90%
8	2006	S.O. 1.2 - Increase health care service availability and accessibility	Customer Results	New Customers and Market Penetration	Percentage of eligible beneficiaries successfully enrolled in the program	90%	92%	92%
9	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Efficiency	Errors	15%	10%	TBD
10	2007	S.O. 1.1 - Broaden health insurance and long-term care coverage	Mission and Business Results	Health Care Administration	Percentage of legislative requirements met	90%	95%	TBD
11	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	85%	90%	TBD
12	2007	S.O. 1.1 - Broaden health insurance and long-term care coverage	Customer Results	New Customers and Market Penetration	Percentage of eligible beneficiaries successfully enrolled in the program	92%	95%	TBD
13	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Efficiency	Errors	TBD	TBD	TBD
14	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
15	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
16	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Satisfaction	Percentage of complaints received (number of payments calculated versus number of complaints received regarding calculation of payments	TBD	TBD	TBD
17	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percent of errors in beneficiary-level withholdings, low income cost savings; plan-level payments; beneficiary-level payments	TBD	TBD	TBD
18	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
19	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
20	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Complaints	Percentage of payments calculated incorrectly (determined by dividing # of incorrect payments by total # payments times 100)	TBD	TBD	TBD
21	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percent of errors in beneficiary-level withholdings, low income cost savings; plan-level payments; beneficiary-level payments	TBD	TBD	TBD
22	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
23	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
24	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Customer Complaints	Percentage of Complaints (number of payments calculated versus number of complaints received regarding calculation of payment)	TBD	TBD	TBD
25	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percent of errors in beneficiary-level withholdings, low income cost savings; plan-level payments; beneficiary-level payments	TBD	TBD	TBD
26	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
27	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
28	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percentage of Complaints (number of payments calculated versus number of complaints received regarding calculation of payment)	TBD	TBD	TBD
29	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
30	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
31	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
32	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percentage of Complaints (number of payments calculated versus number of complaints received regarding calculation of payment)	TBD	TBD	TBD
33	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
34	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percent of change requests associated with a release that perform the intended function and are delivered within the agreed upon time frame	TBD	TBD	TBD
35	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Technology	External Data Sharing	Percentage of information transfers that are complete and within agreed upon time parameters	TBD	TBD	TBD
36	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Accuracy of Service or Product Delivered	Percentage of Complaints (number of payments calculated versus number of complaints received regarding calculation of payment)	TBD	TBD	TBD

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 MMA Title 1 and Title II Applications. 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	Audit Trail Capture and Analysis	Audit Trail Capture and Analysis - Support the identification and monitoring of activities within an application, system, or network.	Security Management	Audit Trail Capture and Analysis			No Reuse	4
2	Identification and Authentication	Defines the set of capabilities that support obtaining information about those parties attempting to log on to a system or application for security purposes and the validation of those users.	Security Management	Identification and Authentication			No Reuse	25
3	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	10
4	Standardized / Canned	Defines the set of capabilities that support the use of pre-conceived or pre-written reports.	Reporting	Standardized / Canned			No Reuse	10
5	Ad Hoc	Defines the set of capabilities that support the use of dynamic reports on an as needed basis.	Reporting	Ad Hoc			No Reuse	4
6	Meta Data Management	Defines the set of capabilities that support the maintenance and administration of data that describes data.	Data Management	Meta Data Management			No Reuse	4
7	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	4
8	Data Integration	Defines the set of capabilities that support the organization of data from separate data sources into a single source using middleware or application integration and the modification of system data models to capture new information within a single system.	Development and Integration	Data Integration			No Reuse	4
9	Software Development	Defines the set of capabilities that support the creation of both graphical and process application or system software.	Development and Integration	Software Development			No Reuse	25
10	Network Management	Defines the set of capabilities that monitor and maintain a communications network in order to diagnose problems, gather statistics and provide general usage.	Organizational Management	Network Management			No Reuse	5
11	Call Center Management	Defines the set of capabilities that handle telephone sales and/or service to the end customer.	Customer Relationship Management	Call Center Management			No Reuse	5

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	Software Development	Service Access and Delivery	Service Requirements	Legislative / Compliance	36 CFR Part 1194
2	Identification and Authentication	Service Access and Delivery	Service Requirements	Authentication / Single Sign-on	BMC EUA
3	Audit Trail Capture and Analysis	Component Framework	Security	Certificates / Digital Signatures	BMC EUA
4	Data Exchange	Component Framework	Data Interchange	Data Exchange	Connect:Direct
5	Data Exchange	Service Interface and Integration	Integration	Enterprise Application Integration	Connect:Direct
6	Data Exchange	Service Access and Delivery	Service Transport	Service Transport	File Transfer Protocol (FTP)
7	Standardized / Canned	Component Framework	Presentation / Interface	Static Display	IBM WebSphere
8	Data Exchange	Service Interface and Integration	Integration	Middleware	IBM WebSphere MQ
9	Network Management	Service Interface and Integration	Integration	Enterprise Application Integration	Medicare Data Center Network (MDCN)
10	Access Control	Service Access and Delivery	Delivery Channels	Virtual Private Network (VPN)	Medicare Data Center Network (MDCN)
11	Meta Data Management	Service Interface and Integration	Interoperability	Data Format / Classification	Microstrategy
12	Meta Data Management	Service Interface and Integration	Interoperability	Data Types / Validation	Microstrategy
13	Ad Hoc	Component Framework	Data Management	Reporting and Analysis	Microstrategy
14	Data Integration	Component Framework	Data Management	Reporting and Analysis	Microstrategy
15	Standardized / Canned	Component Framework	Presentation / Interface	Static Display	Microstrategy
16	Software Development	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	MKS Toolkit
17	Call Center Management	Service Access and Delivery	Delivery Channels	Internet	Windows Internet Explorer
18	Call Center Management	Service Access and Delivery	Delivery Channels	Intranet	Windows Internet Explorer

6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?

no

1. Does the investment have a Risk Management Plan?

yes

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

2007-01-31

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.

2007-07-31

What were the results of your operational analysis?

The system is meeting its performance objectives and the needs of stakeholders are being met. The investment is continually analyzed to ensure continuous service as the provisions of MMA are implemented.