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Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services CMS, Drug Claims (DDPS)

PART ONE

OVERVIEW

1. Date of Submission:: 2008-02-04

2. Agency:: 009

3. Bureau:: 38

4. Name of this Capital Asset:: CMS Drug Claims (DDPS)

5. Unique Project Identifier:: 009-38-01-02-01-1085-00

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 the maintenance & operations for the Drug Data Processing System (DDPS). The primary purpose of DDPS is to collect, maintain & process information on all Medicare covered & non-covered drug events, including non-Medicare drug events, for Medicare beneficiaries participating in Part D voluntary prescription drug coverage under the Medicare program. MMA provided new opportunities to ensure that seniors & people with disabilities receive safe, up-to-date care involving prescription drugs & to develop better evidence on risks, benefits & costs of prescription drugs for Medicare beneficiaries using claims data. The claims data functions serve many critical purposes including effective management/oversight of the Part D benefit, support of quality improvement & medication therapy management activities, collection of new evidence about risks, benefits & costs of prescription drugs, prescribing practices & reconciliation of payments made to plans in the areas of Low Income Cost Sharing, Federal Reinsurance & risk sharing/risk corridors. Medicare obtains a specific set of Part D claims data consisting of 30 data elements based on the National Council for Prescription Drug Programs pharmacy claim format. The Prescription Drug Event (PDE) records are submitted electronically to CMS, validated & stored in a Drug Claims Data repository. The data will also be utilized in the payment reconciliation process of comparing actual expenditures to prospective payments made to plans & correcting any overages/underpayments to plans. The Drug Claims module processes all Medicare covered & non-covered PDEs, including non-Medicare PDEs for Medicare beneficiaries. Each validated/verified PDE is loaded into the Integrated Data Repository. The data is also replicated to the Drug Benefit Calculator. PDE data is used to compute beneficiary/plan utilization, in conjunction with other CMS data on prospective payments, for the purpose of payment reconciliation for LICS, Federal Reinsurance & risk sharing/risk corridor reconciliations. These reconciliations will be performed within the Payment Reconciliation System for a benefit year. DDPS became production ready for 'live' processing on January 1, 2006 and has processed over a billion PDEs. The investment is linked to the CMS strategic Action Plan by supporting High Value Health Care. It also supports Budget Performance Integration, Expanded E-Government & Eliminating Improper Payments under the PMA.

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
Budget Performance Integration
Eliminating Improper Payments
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?): DDPS will enable proper oversight of the Part D Claims process to ensure correct & accurate payments. The records will be submitted to CMS electronically on a monthly basis, thus increasing access. The data stored in this system will enable cost efficiency decisions & support quality improvement & medication therapy management activities.

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?: no

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	3
Services	93
Other	4

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

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 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	28.098	0.000	0.000	0.000
Maintenance Budgetary Resources	0.300	11.544	10.427	21.406
Government FTE Cost	0.360	0.540	0.900	0.927
# of FTEs	4	6	8	8

2. Will this project require the agency to hire additional FTE's?: no

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.

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 Delivery Services	Percentage of legislative requirements met	50% compliance	90% compliance	100% compliance
2	2006	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	20%	15%	22%
3	2006	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	New calculation based on new legislation	99%	100% (as of July, 2006)
4	2006	Effective Management of Human Capital/Information Technology/Resources	Technology	External Data Sharing	Percentage of claims processed electronically	50%	90%	100%
5	2006	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Timeliness	Number of months where provision of the month-end response report exceeded 72 hours target	0	6	2 of 7 months exceeded goal
6	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of legislative requirements met	100%	100% compliance	TBD
7	2007	Effective Management of Human Capital/Information Technology/Resources	Technology	External Data Sharing	Percentage of claims processed electronically	100%	100%	TBD
8	2007	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	15%	12%	TBD
9	2007	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99% accuracy	TBD
10	2007	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Timeliness	Number of months where provision of the month-end response report exceeded 72 hours target	2	5	TBD
11	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of legislative requirements met.	100%	100%	TBD
12	2008	Effective Management of Human Capital/Information Technology/Resources	Technology	External Data Sharing	Percentage of claims processed electronically.	100%	100%	TBD
13	2008	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	TBD	10%	TBD
14	2008	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99% accuracy	TBD
15	2008	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Timeliness	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
16	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of trouble tickets submitted for inability to access data	TBD	10	TBD
17	2009	Effective Management of Human Capital/Information Technology/Resources	Technology	Response Time	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
18	2009	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected	TBD	9%	TBD
19	2009	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99%	TBD
20	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of trouble tickets submitted for inability to access data	TBD	8	TBD
21	2010	Effective Management of Human Capital/Information Technology/Resources	Technology	Response Time	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
22	2010	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected	TBD	8%	TBD
23	2010	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99%	TBD
24	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of trouble tickets submitted for inability to access data	TBD	6	TBD
25	2011	Effective Management of Human Capital/Information Technology/Resources	Technology	Response Time	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
26	2011	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	TBD	7%	TBD
27	2011	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99%	TBD
28	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of trouble tickets submitted for inability to access data	TBD	4	TBD
29	2012	Effective Management of Human Capital/Information Technology/Resources	Technology	Response Time	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
30	2012	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	TBD	6%	TBD
31	2012	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	99%	TBD
32	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Number of trouble tickets submitted for inability to access data	TBD	4	TBD
33	2013	Effective Management of Human Capital/Information Technology/Resources	Technology	Response Time	Number of months where provision of the month-end response report exceeded 72 hours target	TBD	4	TBD
34	2013	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Accuracy of Service or Product Delivered	Percentage of PDEs rejected.	TBD	6%	TBD
35	2013	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Accuracy rate of DDPS data reported and calculated.	TBD	6%	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 Drug Claims (DDPS)

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	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	3
2	Information Sharing	Defines the set of capabilities that support the use of documents and data in a multi-user environment for use by an organization and its stakeholders.	Knowledge Management	Information Sharing	No Reuse	15
3	Information Retrieval	Defines the set of capabilities that allow access to data and information for use by an organization and its stakeholders.	Knowledge Management	Information Retrieval	No Reuse	20
4	Data Classification	Defines the set of capabilities that allow the classification of data.	Data Management	Data Classification	No Reuse	0
5	Data Mart	Defines the set of capabilities that support a subset of a data warehouse for a single department or function within an organization.	Data Management	Data Mart	No Reuse	10
6	Extraction and Transformation	Defines the set of capabilities that support the manipulation and change of data.	Data Management	Extraction and Transformation	No Reuse	10
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	40
8	Instrumentation and Testing	Defines the set of capabilities that support the validation of application or system capabilities and requirements.	Development and Integration	Instrumentation and Testing	No Reuse	0
9	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	0
10	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	0
11	Change Management	Defines the set of capabilities that control the process for updates or modifications to the existing documents, software or business processes of an organization.	Management of Processes	Change Management	No Reuse	2

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	Security	Supporting Security Services	BMC EUA
2	Extraction and Transformation	Service Interface and Integration	Interoperability	Data Transformation	C
3	Extraction and Transformation	Service Interface and Integration	Interoperability	Data Transformation	COBOL
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	Information Sharing	Service Access and Delivery	Access Channels	Other Electronic Channels	Connect:Direct
7	Information Retrieval	Component Framework	Data Management	Database Connectivity	DB2 Connector
8	Data Classification	Service Interface and Integration	Interoperability	Data Format / Classification	ERwin Data Modeler
9	Data Mart	Service Platform and Infrastructure	Database / Storage	Database	IBM DB2
10	Data Integration	Service Interface and Integration	Integration	Middleware	IBM WebSphere MQ
11	Extraction and Transformation	Service Interface and Integration	Interoperability	Data Transformation	Java
12	Instrumentation and Testing	Service Platform and Infrastructure	Software Engineering	Test Management	Manual
13	Change Management	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	MKS Toolkit
14	Software Development	Service Platform and Infrastructure	Software Engineering	Software Configuration Management	MKS Toolkit
15	Data Mart	Service Platform and Infrastructure	Database / Storage	Database	Oracle
16	Data Classification	Service Interface and Integration	Interoperability	Data Format / Classification	Platinum
17	Access Control	Component Framework	Security	Supporting Security Services	Resource Access Control Facility
18	Information Sharing	Service Access and Delivery	Access Channels	Other Electronic Channels	Sterling Commerce Gentran
19	Access Control	Component Framework	Security	Supporting Security Services	Sun Identity Manager
20	Data Mart	Service Platform and Infrastructure	Database / Storage	Database	Teradata

6. Will the application leverage existing components and/or applications across the Government (i.e., FirstGov, Pay.Gov, etc)?: no

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?: 2007-05-23

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.: 2007-07-31

What were the results of your operational analysis?: The analysis was performed by review of all deliverables and stakeholder/customer surveys. The Investment is progressing in accordance with cost, schedule, and performance goals.