Exhibit 300 (BY2010) for CMS Interoperability & Standardization - Provider Enrollment (PECOS)

1. Date of Submission:

2008-09-08

2. Agency:

009

3. Bureau:

38

4. Name of this Capital Asset:

CMS Interoperability & Standardization - Provider Enrollment (PECOS)

5. Unique Project Identifier:

009-38-01-02-01-1115-00

6. What kind of investment will this be in FY2010?

Mixed Life Cycle

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

FY2008

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 PECOS, which is a national repository of all Medicare provider and supplier (p/s) enrollment data. PECOS standardizes the Medicare enrollment process. PECOS retains all information submitted by p/s and only requires updates to the initial enrollment data. The need for p/s practicing in multiple states or billing multiple MC to completely reenroll is eliminated. PECOS makes updating existing information easier, eliminates duplicate data entry and provides uniform data to the FFS claims systems. PECOS R7.0 will be expanded to include Medicaid enrollment. PECOS enables MC (Medicare Contractors) reviewing enrollment applications to determine if an applicant was previously enrolled in Medicare and to identify all of the applicant's affiliations. PECOS improves the accuracy of enrollment data and ensures that only qualified p/s are enrolled with Medicare. PECOS greatly reduces the amount of time needed to process provider enrollment applications. By offering a more complete picture of p/s business operations, PECOS helps to ensure Medicare works only with reputable business partners. As a national enrollment database, PECOS significantly enhances fraud and abuse prevention and enforcement activities since it allows CMS and enrollment MC to view all Medicare activity of a particular p/s. Fraud investigators have a complete national picture of a provider and its managers and owners, allowing them to check for patterns of fraud that cross providers and/or contractor jurisdictions. PECOS also identifies p/s who have been denied privileges, or are subject to revocations or exclusions. PMA: (1) Human Capital: PECOS is a citizen centric business model. P/S are able to manage their own enrollment activities with less dependency on MC. MC spend less time per enrollment activity. (2)Expanded E- Government: PECOS deploys an electronic tool for the p/s community to manage their Medicare enrollment information and reduces the reporting burden on the p/s community. Additionally, the tool reduces errors and ensures completeness of data. (3) Improved Financial Performance: PECOS reduces operational processing costs, increases auto-adjudication rates, and assists CMS in its efforts to reduce fraud and abuse. (4) Eliminate Improper Payment: PECOS improves accuracy of p/s enrollment data that is passed to the FFS claims service and used in the payment process. PECOS R7.0 will extend these benefits to the Medicaid community.

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?

2002-01-05

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
Eliminating Improper Payments
Expanded E-Government
Financial Performance
Human Capital

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?)

PECOS supports financial performance by enhancing fraud/abuse prevention, detection & enforcement activity prior to the provider's approval in the Medicare program & by helping to prevent erroneous payments by supplying enrollment information real-time to the claims systems. PECOS also supports the Expanded E-Government goal by improving provider/suppliers' participation & customer service. Using of the web, PECOS allows CMS to simplify the enrollment of providers and unifies information flows.

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)?

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	1
Services	80
Other	19

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?

no

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 -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	8.888	6.090	16.215	15.525
Government FTE Cost	0.340	0.600	0.371	0.393
# of FTEs	4	6	4	4

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 PECOS do not equal the President's Budget because the CMS portfolio has been adjusted to reflect re-evaluated Agency priorities.

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 Administration	Percentage of Part A&B provider enrollment data housed in PECOS	30%	60%	60%
2	2006	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	90%	95%	99
3	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	76%
4	2006	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	95%	97.76%
5	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	60%	70%	67.9%
6	2007	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	95%	95%	98.2%
7	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	66%
8	2007	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	95%	95.09
9	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider enrollment data housed in PECOS	79%	80%	84.2%
10	2008	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	95%	96%	98.6%
11	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	76%
12	2008	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	95%	96%	91.72%
13	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider enrollment data housed in PECOS	80%	90%	TBD
14	2009	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	96%	97%	TBD
15	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
16	2009	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	96%	97%	TBD
17	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	90%	99%	TBD
18	2010	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percent system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	97%	98%	TBD
19	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%	TBD
20	2010	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	97%	98%	TBD
21	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
22	2011	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	98%	98.5%
23	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
24	2011	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percentage of successful Claims Export availability	98%	98.5%
25	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
26	2012	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	98.5%	99%
27	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
28	2012	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Exprt Jobs complete successfully between 9 pm and 10 pm (Monday through Saturday)	98.5%	99%
29	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
30	2013	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system available to users between the hours of 6 am and 9 pm EST, 5 ays per week except during regularly scheduled maintenance periods	99%	99%
31	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
32	2013	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Exprot Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	99%	99%
33	2014	S.O. 1.3 - Improve health care quality, safety, cost and value	Mission and Business Results	Health Care Administration	Percentage of Part A&B provider data housed in PECOS	95%	99%
34	2014	Effective Management of Human Capital/Information Technology/Resources	Technology	Availability	Percentage of system available to users between the hours of 6 am and 9 pm EST, 5 days per week, except during regularly scheduled maintenance periods	99%	99%
35	2014	S.O. 1.3 - Improve health care quality, safety, cost and value	Customer Results	Response Time	Percentage of initial enrollment applications processed within 60 days	80%	80%
36	2014	S.O. 1.3 - Improve health care quality, safety, cost and value	Processes and Activities	Timeliness	Percent of time FISS and MCS Claims Export Jobs completes successfully between 9 pm and 10 pm (Monday through Saturday)	99%	99%

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 Health Insurance Portability and Accountability Act (HIPAA). In order to provide HHS more detail and insight into our investments, last year's major initiative was split out into a separate investment.

3. Is this investment identified in a completed (contains a target architecture) and approved segment architecture?

no

4. Identify the service components funded by this major IT investment (e.g., knowledge management, content management, customer relationship management, etc.). Provide this information in the format of the following table. For detailed guidance regarding components, please refer to http://www.whitehouse.gov/omb/egov/.

Component: Use existing SRM Components or identify as NEW. A NEW component is one not already identified as a service component in the FEA SRM.

Reused Name and UPI: A reused component is one being funded by another investment, but being used by this investment. Rather than answer yes or no, identify the reused service component funded by the other investment and identify the other investment using the Unique Project Identifier (UPI) code from the OMB Ex 300 or Ex 53 submission.

Internal or External Reuse?: Internal reuse is within an agency. For example, one agency within a department is reusing a service component provided by another agency within the same department. External reuse is one agency within a department reusing a service component provided by another agency in another department. A good example of this is an E-Gov initiative service being reused by multiple organizations across the federal government.

Funding Percentage: Please provide the percentage of the BY requested funding amount used for each service component listed in the table. If external, provide the funding level transferred to another agency to pay for the service.

Row	Agency Component Name	Agency Component Description	Service Type	Component	Reused Component Name	Reused UPI	Internal or External Reuse?	Funding %
1	PECOS Data Warehouse Services	Defines the set of capabilities that support the archiving and storage of large volumes of data.	Data Management	Data Warehouse			No Reuse	96
2	PECOS Data Exchange Services	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	1
3	PECOS Data Classification Services	Defines the set of capabilities that allow the classification of data.	Data Management	Data Classification			No Reuse	1
4	PECOS Loading and Archiving Services	Defines the set of capabilities that support the population of a data source with external data.	Data Management	Loading and Archiving			No Reuse	1
5	PECOS Access Control Services	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	1

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 Warehouse	Service Platform and Infrastructure	Database / Storage	Database	IBM DB2 by: International Business Machines Corp.
2	Data Exchange	Component Framework	Data Interchange	Data Exchange	Connect:Direct by: Sterling Commerce
3	Data Exchange	Service Interface and Integration	Integration	Enterprise Application Integration	Connect:Direct by: Sterling Commerce
4	Data Classification	Component Framework	Data Management	Reporting and Analysis	Crystal Reports by: SAP AG
5	Loading and Archiving	Service Interface and Integration	Integration	Middleware	Sybase EAServer by: Sybase Inc.
6	Loading and Archiving	Service Interface and Integration	Integration	Middleware	DB2 Connector by: International Business Machines Corp.
7	Access Control	Component Framework	Data Interchange	Data Exchange	Connect:Direct by: Sterling Commerce

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?

2008-06-08

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:

Program risk management is an ongoing part of project management on the PECOS program. We have a very robust risk management capability in place that requires monthly meetings with active participation spanning all aspects of the PECOS program. A list of risks is maintained and reviewed each month by Project Manager and development team. The systems integrator and CMS actively work together to identify, manage and track risks that could adversely impact the program. Costs associated with the risk capability are captured in individual task orders and included in the cost estimated throughout the lifecycle of PECOS. Schedule and cost risks are continously monitored and mitigated through our established processes. In some cases, scope and/or schedule must be adjusted to avert cost overruns. Risks associated with added functionality to PECOS are assessed and mitigation and/or contingency plans are developed as necessary. Risks relative to government mandates are managed within existing risk management processes. Risks are reported to all business partners and stakeholders. Risks are identified as to their impact to the release work schedule including the critical path and the budget. The Risk Management Plan is reviewed at the beginning of each release. Initial costs for the PECOS investment were analyzed as part of the project business case. These costs are reviewed yearly and any necessary adjustments are made to account for funding discrepancies. Funding is also aligned and updated as appropriate based upon operational budgets as established by the department. Any risk identified in the PECOS Risk Management plan will be mapped back to the performance measurement baseline to ensure they have been sufficiently addressed.

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%?

yes

2.a. If yes, was it the?

SV

2.b. If yes, explain the variance.

Currently the Budget At Completion (Planned Costs) in ProSight is $16.215 million, but the FY09 budget has this project receiving only $6.090 million. The Actual % Completed is based on FY08 funding the first three months of FY09. The Actual Invoiced amount through December 1, 2009, is $1,468,842, which is 91.9% of the amount on the current contract is $1,598,008. Since this number is compared to the Planned Invoice, which represents three months out of twelve months (25%), there is a variance. Contract modifications have not been completed to apply FY09 money; that will be taking place shortly, and should correct both issues. Milestone 29, FY08 Release 7.0 One Stop Shop Combined Medicare & Medicaid Enrollment, is being implemented in a different manner. Currently the contract is being modified to account for a different execution strategy. It will be recommended that this Milestone be broken into two Milestones, re-baselined, and tracked separately. Currently the Statement of Work is being prepared and in the next month the contract should be modified to account for the different execution strategy. Background: In the April/May 2008 timeframe it was determined that the current execution strategy was not going to be successful. From April through December 2008, CMS/OFM worked with CMS/CMSO to come up with a different execution strategy that accomplishes the same goal. The Contractor was given guidance in August 2008 and a Technical Direction Letter in September 2008 indicating it should only work on the tasks associated directly with incorporating the DME suppliers into PECOS and with updating the PECOS architecture. This guidance caused spending to slow down, work schedules to change, and contributed to the positive cost variance.

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

This investment will be re-baselined with the FY 2011 budget cycle review.

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

yes

3.a. If yes, when was it approved by the agency head?

2008-07-03