HHS Home > OCIO Home > Capital Planning & Budget > Exhibit 300

Exhibit 300 (BY2010) for CMS Interoperability & Standardization - Provider ID (NPPES)

PART ONE

OVERVIEW

1. Date of Submission:: 2008-09-08

2. Agency:: 009

3. Bureau:: 38

4. Name of this Capital Asset:: CMS Interoperability & Standardization - Provider ID (NPPES)

5. Unique Project Identifier:: 009-38-01-02-01-3100-00

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?: FY2001 or earlier

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 National Plan and Provider Enumeration System (NPPES) is the system that enumerates health plans and providers in compliance with the requirements of HIPAA. HIPAA requires the Secretary of Health and Human Services to adopt a national standard identifier for all health plans and providers for use in the health care system. This scope extends to all heath plans and providers not just Medicare and Medicaid. NPPES processes applications from health care providers for National Provider Identifiers (NPIs). NPIs are identification numbers that health care providers are required by regulation to obtain and use to identify themselves in electronic health transactions, such as electronic claims and eligibility inquiries. NPIs do not change and do not expire. NPPES captures, by application, identifying information about health care providers. It processes each application to ensure the uniqueness of the health care provider, and then assigns the health care provider its NPI. NPPES establishes a record for every health care provider it enumerates. NPPES processes updates and changes to the data in an enumerated health care provider's record and deactivates and reactivates a health care provider's NPI upon request by the health care provider. The NPPES makes available, upon approved requests, information about each enumerated health care provider, including the NPI. NPPES assists with reducing the incidence of provider misidentificatio n. It helps to differentiate between fraudulent providers and those who make honest billing mistakes. It allows for easy access to obtain NPIs. Finally, it supports defining, developing, implementing, and maintaining uniform data standards for the exchange of health care information in our programs, as well as across the nation's health care system. This system went into production during FY 2006 with no major planned enhancements. This menas the current solution is still the best alternative solution. NPPES supports HHS & PMA goals such as Expanded E-Government by implementing a web-based application for providers to obtain their NPI, improving system and technology information management, providing efficient business processes, and maintaining data itegrity . This investment will be in the evaluate phase during FY 2007 & 2008.

9. Did the Agency's Executive/Investment Committee approve this request?: yes

9.a. If "yes," what was the date of this approval?: 2008-03-26

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?: Waiver Issued

11.b. When was the Program/Project Manager Assigned?: 2008-01-05

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

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?): NPPES supports Expanding E-Government by implementing a web-based application for providers to obtain an NPI. It allows health care providers to submit an electronic application for enumeration & to make updates to data, including deactivations via the web site. It improves systems & technology info. mgmt. for federal, state, & local governments & contractors. By using E-Gov strategies, NPPES provides efficient business processes & helps to maintain data integrity in a cost effective manner.

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%)

Area	Percentage
Hardware	7
Software	12
Services	81
Other

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?: yes

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 -2007	PY 2008	CY 2009	BY 2010
Planning Budgetary Resources	0.000	0.000	0.000	0.000
Acquisition Budgetary Resources	0.000	0.000	0.000	0.000
Maintenance Budgetary Resources	16.661	2.026	2.419	2.188
Government FTE Cost	0.195	0.150	0.159	0.112
# of FTEs	2	2	2	1

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

3. If the summary of spending has changed from the FY2008 President's budget request, briefly explain those changes.: The current funding levels for this investment were developed through the CMS' annual CPIC process. The funding levels for NPPES do not equal the President's Budget because the CMS portfolio has been adjusted to reflect re-evaluated Agency priorities.

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	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(pending applications) Percentage of existing health care providers receiving an NPI	0%	100%	91%
2	2006	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	95%	98%	93%
3	2006	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	7	5	1
4	2006	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	20%	15%	30%
5	2007	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(pending applications) Percentage of existing health care providers receiving an NPI	100%	100%	97%
6	2007	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%	94%
7	2007	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	3	1
8	2007	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%	29%
9	2008	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%	100%
10	2008	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%	93%
11	2008	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5	1
12	2008	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%	30%
13	2009	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%	TBD
14	2009	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%	TBD
15	2009	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5	TBD
16	2009	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%	TBD
17	2010	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%	TBD
18	2010	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%	TBD
19	2010	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5	TBD
20	2010	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%	TBD
21	2007	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Delivery Time	Number of days for Enumerator to process a clean paper application	20	20	17
22	2007	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30	26
23	2008	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days for Enumerator to process a clean paper application	20	20	16
24	2008	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30	27
25	2009	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days for Enumerator to process a clean paper application	20	20	TBD
26	2009	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30	TBD
27	2010	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days for Enumerator to process a clean paper application	20	20	TBD
28	2010	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30	TBD
29	2007	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100%	100%	100%
30	2008	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100	100%	TBD
31	2009	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100	100%	TBD
32	2010	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100	100%	TBD
33	2011	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30
34	2011	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Delivery Time	Number of days for Enumerator to process a clean paper application	20	20
35	2011	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100%	100%
36	2011	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5
37	2011	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%
38	2011	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%
39	2011	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%
40	2012	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%
41	2012	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%
42	2012	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%
43	2012	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30
44	2012	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5
45	2012	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Delivery Time	Number of days for Enumerator to process a clean paper application	20	20
46	2012	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100%	100%
47	2013	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%
48	2013	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%
49	2013	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%
50	2013	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30
51	2013	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5
52	2013	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Delivery Time	Number of days for Enumerator to process a clean paper application	20	20
53	2013	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100%	100%
54	2014	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	(new applications) Percentage of new applicants receiving an NPI	100%	100%
55	2014	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system availability	93%	93%
56	2014	Effective Management of Human Capital/Information Technology/Resources	Processes and Activities	Errors	Percent of web cases that require manual intervention	30%	30%
57	2014	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of day for Enumerator to process un-clean paper applications	30	30
58	2014	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Response Time	Number of days to process a clean web application	5	5
59	2014	Effective Management of Human Capital/Information Technology/Resources	Customer Results	Delivery Time	Number of days for Enumerator to process a clean paper application	20	20
60	2014	Effective Management of Human Capital/Information Technology/Resources	Mission and Business Results	Health Care Administration	Percent of NPPES data available for Data Dissemination	100%	100%

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 Interoperability and Standardization - Provider Identification

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	NPPES Electronic File Interchange (EFI) Information Exchange Service	NPPES provides an Electronic File Interchange (EFI)	Data Management	Data Exchange			No Reuse	50
2	NPPES provides Workload Reports for the Enumerator Contractor.	NPPES provides Workload Reports for the Enumerator Contractor.	Reporting	Standardized / Canned			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	Connect:Direct by: Sterling Commerce
2	Data Exchange	Service Access and Delivery	Delivery Channels	Extranet	IBM HTTP Server 5.1 by: International Business Machines Corp.
3	Data Exchange	Component Framework	Data Interchange	Data Exchange	SOAP by: World Wide Web Consortium
4	Data Exchange	Service Interface and Integration	Integration	Enterprise Application Integration	Connect:Direct by: Sterling Commerce
5	Standardized / Canned	Component Framework	Data Management	Reporting and Analysis	TBD

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?: 2008-01-15

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.: 2007-09-10

What were the results of your operational analysis?: This investment still meets the needs of its stakeholders and users. An operational analysis was performed and the project is within the 10 percent cost and schedule variance. We are on target to meet the milestones per the approved baseline. The system was implemented to meet CMS requirements and needs.