Exhibit 300 (BY2009) - Centers for Medicare and Medicaid Services -Medicare Integrity Program Modernization - One PI System

1. Date of Submission:

2008-02-04

2. Agency:

009

3. Bureau:

38

4. Name of this Capital Asset:

CMS Medicare Integrity Program Modernization - One PI System

5. Unique Project Identifier:

009-38-01-06-01-1015-00

6. What kind of investment will this be in FY2009?

Planning

7. What was the first budget year this investment was submitted to OMB?

FY2009

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 primary purpose of the One PI system is to establish an enterprise resource that will provide a single source of information for all CMS fraud, waste, and abuse activities. The project, begun in FY 2006, will, for the first time, provide streamlined, centralized access and analysis for standardized Medicaid data across multiple states, integrated with data from Medicare Parts A, B, and D. The availability of a centralized source for accessing the tremendous volume of data on claims, providers, and beneficiaries will enable consistent, reliable, and timely analyses, improving the ability to detect fraud, waste, and abuse in both programs--the primary business goal for One PI. The One PI project supports the CMS strategic action plan and addresses legislative requirements, and will provide support to 4 systems in OMB's PART program: Medicare, Medicaid, Program Integrity and Health Care Fraud. The CMS strategic action plan specifically states the goal of establishing "an integrated data repository" to support the modernization of program integrity. The One PI project will allow for the efficient expansion of the agency's Medi-Medi data match project as required in the Deficit Reduction Act of 2005. Centralizing Medicare and Medicaid data in this one system will create efficiencies for CMS' CMSO, ORDI, and OCSQ components; contractors, such as MEDICs, PSCs, and Medi-Medi PSCs; state Medicaid agencies; and law enforcement. The effort supports provisions in the Benefits Improvement and Protection Act of 2000 and the Part D program components of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as well as the PMA goal of Improved Financial Payments by reducing improper payments of all types. The program leverages two data repositories: the Integrated Data Repository (IDR) and the new One PI Data Repository (ODR). Both the IDR and the ODR use the NCR Teradata platform. The One PI application suite will begin with Medstat Advantage Suite, a COTS decision support tool linked to an integrated data warehouse used to perform sophisticated data analyses; Business Objects, a suite of query and analysis tools used for business intelligence; portal collaboration and communication tools. It will evolve at user direction to include products such as SAS, sampling software and reporting tools.

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?)

The program will improve financial performance and reduce improper payments through integrated Medicare and Medicaid data and advance applications to analyze fraud, waste and abuse. Standardizing Medicaid data will permit multi-state and national analysis and improved Medicare/Medicaid comparisons. Episode of care data will be used to assess healthcare quality and potential fraud. One PI supports e-Gov by increasing collaboration across the states and Medicare/Medicaid.

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?

2002: CMS - Medicare Integrity Program

14.c. If yes, what rating did the PART receive?

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

19.a.2. If no, what does it address?

The One PI attack on fraud, waste and abuse supports 4 programs on the OMB PART list: Medicare Program Integrity, Medicare and Medicaid, which are all rated effective, but with weaknesses; and the Health Care Fraud and Abuse program which has not demonstrated effective results. Weaknesses include susceptibility to fraud, waste and abuse and improper payments.

20. What is the percentage breakout for the total FY2009 funding request for the following? (This should total 100%)

Area	Percentage
Hardware	34
Software	0
Services	66
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	14.567	0.000	0.000	0.000
Acquisition Budgetary Resources	0.000	10.634	3.793	23.300
Maintenance Budgetary Resources	0.000	0.000	0.000	0.000
Government FTE Cost	0.000	0.300	0.309	0.321
# of FTEs	0	3	3	3

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

yes

2.a. If "yes," how many and in what year?

Using PY-1 2006, the government will be required to hire six new FTEs in PY 2007, two new FTEs in CY 2008, two new FTEs in BY 2009, two new FTEs in BY+1 2010, and two new FTEs in BY+2 2011.

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	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 6 new states put into the One PI System through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
2	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states that are using the system	2	8 states	TBD
3	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percent of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the system based on survey results.	TBD (from 2008)	67% or higher	TBD
4	2009	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the One PI System complies with existing HITSP standards	TBD (from 2008)	100%	TBD
5	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 10 new states put into the One PI System through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
6	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states who are using the system	8 states	18 states	TBD
7	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percentage of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the One PI System based on survey results.	TBD (from 2009)	69% or higher	TBD
8	2010	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the One PI system complies with existing HITSP standards	TBD (from 2009)	100%	TBD
9	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Durable Medical Equipment (DME) error rate for the 2 new DME PSCs through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	5.55%	5.05%	TBD
10	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of DME PSCs that are using the system resulting in a reduction of duplicate data centers.	2	4 DME PSCs	TBD
11	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percentage of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the system based on survey results.	TBD (from 2010)	71% or higher	TBD
12	2011	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the system complies with existing HITSP standards	TBD (from 2010)	100%	TBD
13	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part A error rate for the 2 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	7.85%	7.35%	TBD
14	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of PSCs that are using the system resulting in a reduction of duplicate data centers.	5	7 PSCs	TBD
15	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percentage of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the system based on survey results.	TBD (from 2011)	73% or higher	TBD
16	2012	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the system complies with existing HITSP standards	TBD (from 2011)	100%	TBD
17	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 11 new states put into the system through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
18	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states that are using the system	39	50 states	TBD
19	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percentage of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the system based on survey results.	TBD (from 2012)	75% or higher	TBD
20	2013	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the system complies with existing HITSP standards	TBD (from 2012)	100%	TBD
21	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of MEDICs that are using the system resulting in a reduction of duplicate data centers.	None	1 MEDIC	TBD
22	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSC contractors that are using the system resulting in a reduction of duplicate data centers.	2	8 Medi-Medi PSC contractors	TBD
23	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of DME PSCs that are using the system resulting in a reduction of duplicate data centers.	None	2 DME PSCs	TBD
24	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of MEDICs that are using the system resulting in a reduction of duplicate data centers.	1	3 MEDICs	TBD
25	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of PSCs that are using the system resulting in a reduction of duplicate data centers.	None	2 PSCs	TBD
26	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states that are using the system	28	39 states	TBD
27	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the DME error rate for the 2 new DME PSCs put into the One PI System through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	5.55%	5.05%	TBD
28	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part A error rate for the 2 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	7.85%	7.35%	TBD
29	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part B (excluding DME) error rate for the 2 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	5.35%	4.85%	TBD
30	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part A error rate for the 3 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	7.85%	7.35%	TBD
31	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part B error rate for the 3 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	5.35%	4.85%	TBD
32	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 10 new states put into the system through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
33	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of PSCs who are using the system resulting in a reduction of duplicate data centers.	2	5 PSCs	TBD
34	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states that are using the system	18	28 states	TBD
35	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Part B error rate for the 2 new PSCs put into the system through increased detection of FWA by using the One PI System and through increased communication between federal entities via the System.	5.35%	4.85%	TBD
36	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 11 new states put into the system through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
37	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSCs that are using the system resulting in a reduction of duplicate data centers.	8	18 Medi-Medi PSCs	TBD
38	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSCs that are using the system resulting in a reduction of duplicate data centers.	18	28 Medi-Medi PSCs	TBD
39	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSCs that are using the system resulting in a reduction of duplicate data centers.	28	39 Medi-Medi PSC	TBD
40	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSCs that are using the system resulting in a reduction of duplicate data centers.	None	2 Medi-Medi PSCs	TBD
41	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of states and territiories using the system	None	2 states	TBD
42	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Errors	The percentage of new and existing users who are "satisfied" or "highly satisfied" with the analytic capabilities of the system based on survey results.	TBD	65% or higher	TBD
43	2008	Effective Management of Human Capital/Information Technology/Resources	Technology	Compliance and Deviations	The extent to which the system complies with existing HITSP standards	TBD	100%	TBD
44	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Program Monitoring	A decrease in the Medicaid error rate for the 2 new states put into the system through increased detection of FWA by using the One PI System and through increased communication between federal and state entities via the System.	10%	9.5%	TBD
45	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	New Customers and Market Penetration	The number of Medi-Medi PSC contractor that are using the system resulting in a reduction of duplicate data centers.	None	2 Medi-Medi PSCs	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?

no

2.b. If no, please explain why?

Investment identified after the most recent transition plan and will be included in the next release

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	Data Warehouse	Defines the set of capabilities that support the archiving and storage of large volumes of data.	Data Management	Data Warehouse			No Reuse	50
2	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	50

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	Data Exchange	Component Framework	Data Interchange	Data Exchange	TBD
2	Data Warehouse	Service Platform and Infrastructure	Database / Storage	Database	TBD

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?

2006-12-13

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

no

3. Briefly describe how investment risks are reflected in the life cycle cost estimate and investment schedule:

The benefits have been adjusted based on technological risks and the implementation schedule of states and other customers. We have developed a cost and benefit model that will allow us to adjust both values (technological risks and the schedule) if states and other customers change from the planned implementation schedule. Life cycle costs, and costs for each alternative, are risk-adjusted for every fiscal year. The risk adjustment is a percentage of the cost based on the probability of occurrence and potential impact. The risk is not calculated as a single factor for the entire project; rather, the risk adjustment may vary among years and across life cycle phases. The investment schedule has been adjusted to reflect the impact of risks that have occurred or may occur.

1. Does the earned value management system meet the criteria in ANSI/EIA Standard 748?

yes

2. Is the CV% or SV% greater than ± 10%?

no

2.b. If yes, explain the variance.

The cost variance is high because CMS was billed for software licensing in FY07 that should have been spread across three years (FY 07-09). This results in a cost overage for a milestone in FY07, but costs should be less than originally planned for FY08 and FY09.

2.c. If yes, what corrective actions are being taken?

The cost variance will correct itself over the next two years.

3. Has the investment re-baselined during the past fiscal year?

no