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Exhibit 300 (BY2010) - CMS Drug Claims (DDPS)

PART ONE


OVERVIEW


1. Date of Submission:
2008-09-08
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 FY2010?
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 and operations for the Drug Data Processing System (DDPS). The primary purpose of DDPS is to collect, maintain, and process information on all Medicare drug events for people with Medicare who have enrolled into a Medicare Part D plan. The system helps CMS determine appropriate payment of covered drugs. DDPS will provide for processing, storing, and maintaining drug transaction data in a large-scale database, while putting data into data marts to support payment analysis. Medicare obtains a specific set of Part D claims data consisting of 30 data elements from all drug claims. The Prescription Drug Event (PDE) records are submitted electronically to CMS on a monthly basis, validated, and stored in a Drug Claims Data repository. The data are further utilized in the payment reconciliation process which compares actual expenditures to prospective payments made to plans and corrects any overages or underpayments to plans. This reconciliation supports the intent of the PMA Initiative to Improve Financial Performance. DDPS supports the HHS Strategic Objective 1.1: Broaden health insurance and long-term care coverage. Specifically, DDPS is a crucial system in delivering the Medicare Part D coverage.
9. Did the Agency's Executive/Investment Committee approve this request?
yes
9.a. If "yes," what was the date of this approval?
2008-04-04
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?
Waiver Issued
11.b. When was the Program/Project Manager Assigned?
2007-01-01
11.c. What date did the Program/Project Manager receive the FACP/PM certification? If the certification has not been issued, what is the anticipated date for certification?
2009-07-31
12. Has the agency developed and/or promoted cost effective, energy-efficient and environmentally sustainable techniques or practices for this project.
no
12.a. Will this investment include electronic assets (including computers)?
yes
12.b. Is this investment for new construction or major retrofit of a Federal building or facility? (answer applicable to non-IT assets only)
no
13. Does this investment directly support one of the PMA initiatives?
yes
If yes, select the initiatives that apply:
Initiative Name
Expanded E-Government
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?)
DDPS enables proper oversight of the Part D Claims process to ensure correct and accurate payments. The records are submitted to CMS electronically on a monthly basis, thus increasing access. The data stored in this system enables cost efficiency decisions, supports quality improvement, and 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?
yes
14.b. If yes, what is the name of the PARTed program?
10001060 - Medicare
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%)
AreaPercentage
Hardware0
Software5
Services95
Other0
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.
NameMaribel Franey
Phone Number410-786-0757
TitleDirector, Privacy Compliance
Emailmaribel.franey@cms.hhs.gov
23. Are the records produced by this investment appropriately scheduled with the National Archives and Records Administration's approval?
yes
24. Does this investment directly support one of the GAO High Risk Areas?
yes

SUMMARY OF SPEND


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

All amounts represent Budget Authority

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

Government FTE Costs should not be included as part of the TOTAL represented.
Cost TypePy-1 & Earlier
-2007
PY
2008
CY
2009
BY
2010
Planning Budgetary Resources0.0000.0000.0000.000
Acquisition Budgetary Resources0.0000.0000.0000.000
Maintenance Budgetary Resources11.54412.45321.40615.406
Government FTE Cost0.5400.9000.9270.955
# of FTEs6888
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.
RowFiscal YearStrategic Goal SupportedMeasurement AreaMeasurement GroupingMeasurement IndicatorBaselinePlanned Improvement to the BaselineActual Results
12006S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care AdministrationPercentage of legislative requirements met50% compliance90% compliance100% compliance
22006Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.20%15%22%
32006Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsAccuracy rate of DDPS data reported and calculated.New calculation based on new legislation99%99%
42006Effective Management of Human Capital/Information Technology/ResourcesTechnologyIT Contribution to Process, Customer, or MissionPercentage of claims processed electronically50%90%100%
52006Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesTimelinessNumber of months where provision of the month-end response report exceeded 72 hours target654
62007S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care AdministrationPercentage of legislative requirements met100%100% compliance100%
72007Effective Management of Human Capital/Information Technology/ResourcesTechnologyIT Contribution to Process, Customer, or MissionPercentage of claims processed electronically100%100%100%
82007Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.15%12%12%
92007Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsAccuracy rate of DDPS data reported and calculated.99%99% accuracy99%
102007Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours target433
112008S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care AdministrationPercentage of legislative requirements met.100%100%100
122008Effective Management of Human Capital/Information Technology/ResourcesTechnologyIT Contribution to Process, Customer, or MissionPercentage of claims processed electronically.100%100%100
132008Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.12%10%5%
142008Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.99%99% accuracy99%
152008Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours target322%
162009S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access data1010TBD
172009Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours target22TBD
182009Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected5%9%TBD
192009Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.99%99%TBD
202010S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access dataTBD8TBD
212010Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours targetTBD1TBD
222010Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejectedTBD8%TBD
232010Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.TBD99%TBD
242011S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access dataTBD6TBD
252011Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours targetTBD1TBD
262011Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.TBD7%TBD
272011Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.TBD99%TBD
282012S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access dataTBD4TBD
292012Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours targetTBD1TBD
302012Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.TBD6%TBD
312012Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.TBD99%TBD
322013S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access dataTBD4TBD
332013Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours targetTBD1TBD
342013Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.TBD6%TBD
352013Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.TBD6%TBD
362014S.O. 1.3 - Improve health care quality, safety, cost and valueMission and Business ResultsHealth Care Delivery ServicesNumber of trouble tickets submitted for inability to access dataTBD4TBD
372014Effective Management of Human Capital/Information Technology/ResourcesTechnologySystem Response TimeNumber of months where provision of the month-end response report exceeded 72 hours targetTBD1TBD
382014Effective Management of Human Capital/Information Technology/ResourcesCustomer ResultsAccuracy of Service or Product DeliveredPercentage of PDEs rejected.TBD5%TBD
392014Effective Management of Human Capital/Information Technology/ResourcesProcesses and ActivitiesErrorsPercent of accurate DDPS data reported and calculated.TBD6%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.
RowAgency Component NameAgency Component DescriptionService TypeComponentReused Component NameReused UPIInternal or External Reuse?Funding %
1DDPS Access Control ServiceAccess Control - Support the management of permissions for logging onto a computer, application, service, or network; includes user management and role/privilege management.Security ManagementAccess Control  No Reuse3
2DDPS Instrumentation and Testing ServiceDefines the set of capabilities that support the validation of application or system capabilities and requirements.Development and IntegrationInstrumentation and Testing  No Reuse0
3DDPS Data Integration ServiceDefines 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 IntegrationData Integration  No Reuse0
4DDPS Data Mart ServiceDefines the set of capabilities that support a subset of a data warehouse for a single department or function within an organization.Data ManagementData Mart  No Reuse10
5DDPS Data Classification ServiceDefines the set of capabilities that allow the classification of data.Data ManagementData Classification  No Reuse0
6DDPS Information Retrieval ServiceDefines the set of capabilities that allow access to data and information for use by an organization and its stakeholders.Knowledge ManagementInformation Retrieval  No Reuse20
7DDPS Information Sharing ServiceDefines 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 ManagementInformation Sharing  No Reuse15
8DDPS Change Management ServiceDefines 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 ProcessesChange Management  No Reuse2
9DDPS Extraction and Transformation ServiceDefines the set of capabilities that support the manipulation and change of data.Data ManagementExtraction and Transformation  No Reuse10
10DDPS Data Exchange ServiceDefines the set of capabilities that support the interchange of information between multiple systems or applications; includes verification that transmitted data was received unaltered.Data ManagementData Exchange  No Reuse40
11DDPS Software Development ServiceDefines the set of capabilities that support the creation of both graphical and process application or system software.Development and IntegrationSoftware Development  No Reuse0
5. To demonstrate how this major IT investment aligns with the FEA Technical Reference Model (TRM), please list the Service Areas, Categories, Standards, and Service Specifications supporting this IT investment.

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

Service Specification: In the Service Specification field, Agencies should provide information on the specified technical standard or vendor product mapped to the FEA TRM Service Standard, including model or version numbers, as appropriate.
RowSRM Component>Service AreaService CategoryService StandardService Specification (i.e., vendor and product name)
1Access ControlComponent FrameworkSecuritySupporting Security ServicesBMC EUA by: TBD
2Access ControlComponent FrameworkSecuritySupporting Security ServicesSun Identity Manager by: Sun Microsystems, Inc.
3Access ControlComponent FrameworkSecuritySupporting Security ServicesResource Access Control Facility by: International Business Machines Corp.
4Instrumentation and TestingService Platform and InfrastructureSoftware EngineeringTest ManagementMKS Toolkit by: MKS Inc.
5Data IntegrationService Interface and IntegrationIntegrationMiddlewareIBM WebSphere MQ by: International Business Machines Corp.
6Data MartService Platform and InfrastructureDatabase / StorageDatabaseIBM DB2 by: International Business Machines Corp.
7Data MartService Platform and InfrastructureDatabase / StorageDatabaseOracle by: Oracle Corporation
8Data ClassificationService Interface and IntegrationInteroperabilityData Format / ClassificationERwin Data Modeler by: TBD
9Information RetrievalComponent FrameworkData ManagementDatabase ConnectivityDB2 Connector by: International Business Machines Corp.
10Information SharingService Access and DeliveryAccess ChannelsOther Electronic ChannelsConnect:Direct by: Sterling Commerce
11Change ManagementService Platform and InfrastructureSoftware EngineeringSoftware Configuration ManagementMKS Toolkit by: MKS Inc.
12Extraction and TransformationService Interface and IntegrationInteroperabilityData TransformationC by: ANSI
13Extraction and TransformationService Interface and IntegrationInteroperabilityData TransformationJava by: Sun Microsystems, Inc.
14Extraction and TransformationService Interface and IntegrationInteroperabilityData TransformationCOBOL by: TBD
15Data ExchangeService Interface and IntegrationIntegrationEnterprise Application IntegrationConnect:Direct by: Sterling Commerce
16Data ExchangeComponent FrameworkData InterchangeData ExchangeConnect:Direct by: Sterling Commerce
17Software DevelopmentService Platform and InfrastructureSoftware EngineeringSoftware Configuration ManagementMKS Toolkit by: MKS Inc.
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?
2008-05-23
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.
2008-07-30
What were the results of your operational analysis?
The analysis involved reviewing all deliverables and stakeholder/customer surveys. This investment continues to perform within the cost and schedule thresholds established by HHS and CMS and is expected to meet projected milestones. DDPS is meeting the defined performance goals for the system. The project team regularly meets with customers and stakeholders on developing expectations. Customers and stakeholders are and will continue to be involved in both refining metrics parameters, and in a feedback loop towards future performance and quality.