Exhibit 300 (BY2010) for CMS Plan Enrollment (HPMS)
PART ONE
OVERVIEW
- 1. Date of Submission:
- 2008-09-08
- 2. Agency:
- 009
- 3. Bureau:
- 38
- 4. Name of this Capital Asset:
- CMS Plan Enrollment (HPMS)
- 5. Unique Project Identifier:
- 009-38-01-02-01-1075-00
- 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?
- FY2005
- 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 Health Plan Management System (HPMS) collects data for and manages the following plan enrollment processes for the MA and Part D programs: application process, bid/benefit package submissions, formulary submissions, marketing material reviews, plan oversight, complaints tracking, survey data, operational data feeds for enrollment and payment, and data support for the Medicare & You handbook and www.medicare.gov website. HPMS supports these processes for all private plans participating in the MA and Part D programs. As the central e-government system for managing the day-to-day operations of these programs, HPMS ensures that there is a single mechanism by which plans and CMS can communicate electronically in an easy and efficient manner. With limited staff resources, HPMS is critical to CMS in managing the over 700 MA and PDP organizations to ensure that they are fulfilling the significant number of statutory, regulatory, and administrative requirements of the MA and Part D programs. The efficiencies produced by HPMS are also vital in enabling CMS to review and approve the ever-increasing number of new plans, which in turn leads to a greater and more diverse set of benefit package options available to Medicare beneficiaries. HPMS supports the "Expanded Electronic Government" government-wide initiative on the PMA and the "High-Value Health Care" and "Confident, Informed Consumers" objectives of the CMS Strategic Action Plan. This investment makes significant contributions to an expanded e-government, implementation of the Federal Enterprise Architecture, and CMS' IT modernization blueprint. It builds the basic computing infrastructure needed to support several CMS systems; supports common standards and practices; and integrates security and privacy protections throughout the lifecycle. With HPMS, CMS will focus on improving services to citizens and other CMS customers through the use of web-based communication and data transfer and various e-business technologies that depend on the Internet. This initiative will provide tools and capabilities to improve internal CMS operations and enable robust collaboration between CMS and its business partners. In an operations and maintenance state, HPMS will use future funding to maintain current operations (e.g., system/database administration, data processing/exchanges, web hosting infrastructure, and telecommunications) and perform routine updates to existing HPMS modules in response to policy changes.
- 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?
- 2002-07-14
- 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?)
- E-Gov (managing partner) - HPMS provides a single point of access via the Internet for CMS information, services, and products. HPMS enables MA/Part D plans to submit application, formulary, bid, marketing, and oversight data via online web data entry pages and file uploads. State and Federal agencies benefit from the ease with which they can retrieve and analyze MA/Part D program data via the HPMS portal. Beneficiaries use HPMS benefit and performance data on medicare.gov to make plan choices.
- 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 6 Software 1 Services 93 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?
- 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
-2007PY
2008CY
2009BY
2010Planning Budgetary Resources 0.000 0.000 0.000 0.000 Acquisition Budgetary Resources 0.000 0.000 0.000 0.000 Maintenance Budgetary Resources 10.698 10.922 16.509 11.933 Government FTE Cost 0.615 1.400 1.034 1.065 # of FTEs 2 14 11 11
- 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.
- 1 - Additional funding has been included in the Summary of Spending for 2008. This increase has resulted from the provision of RAC (Recovery Audit Contractors) funding to the HPMS investment to support additional plan compliance functionality. The acquisition plan has been updated, accordingly. 2 - The increase in the Summary of Spending for HPMS for 2009 as compared to the FY 2009 President's budget request is due to several factors: a) the need to contract out remaining in-house web development to the private sector because of a recent CMS reorganization, and b) the need to increase maintenance budget to account for the workload that results from the infusion of FY 2008 RAC funding.
PERFORMANCE
In order to successfully address this area of the exhibit 300, performance goals must be provided for the agency and be linked to the annual performance plan. The investment must discuss the agency's mission and strategic goals, and performance measures (indicators) must be provided. These goals need to map to the gap in the agency's strategic goals and objectives this investment is designed to fill. They are the internal and external performance benefits this investment is expected to deliver to the agency (e.g., improve efficiency by 60 percent, increase citizen participation by 300 percent a year to achieve an overall citizen participation rate of 75 percent by FY 2xxx, etc.). The goals must be clearly measurable investment outcomes, and if applicable, investment outputs. They do not include the completion date of the module, milestones, or investment, or general goals, such as, significant, better, improved that do not have a quantitative measure.
- Agencies must use the following table to report performance goals and measures for the major investment and use the Federal Enterprise Architecture (FEA) Performance Reference Model (PRM). Map all Measurement Indicators to the corresponding Measurement Area and Measurement Grouping identified in the PRM. There should be at least one Measurement Indicator for each of the four different Measurement Areas (for each fiscal year). The PRM is available at www.egov.gov. The table can be extended to include performance measures for years beyond FY 2009.
Row Fiscal Year Strategic Goal Supported Measurement Area Measurement Grouping Measurement Indicator Baseline Planned Improvement to the Baseline Actual Results 1 2006 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of contracts processed in HPMS 93% 95% 97% 2 2006 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Delivery Time Percent of HPMS help desk inquiries completed within 24 hours 93% 95% 97% 3 2006 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of successful monthly data updates to the www.medicare.gov web tools as well as quarterly data updates to the Medicare & You handbook. 90% 95% 93% 4 2006 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. EST. 93% 95% 98% 5 2007 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of contracts processed in HPMS 95% 97% 98% 6 2007 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours 95% 97% 97% 7 2007 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of successful monthly data updates to the www.medicare.gov web tools as well as quarterly data updates to the Medicare & You handbook. 95% 97% 96% 8 2007 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. EST. 95% 97% 98% 9 2007 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of unload processing for bids within the specified time period. 95% 97% 97% 10 2007 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of complete unload processing of annual formulary submissions within 4 business days following due date. 95% 97% 97% 11 2008 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of complete unload processing of annual bid submissions within 4 business days following due date. 97% 99% 98% 12 2008 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of contracts processed in HPMS 97% 99% 99% 13 2008 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Delivery Time Percent of HPMS help desk inquiries completed within 24 hours 97% 99% 98% 14 2008 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of successful monthly data updates to the www.medicare.gov web tools as well as quarterly data updates to the Medicare & You handbook. 97% 99% 99% 15 2008 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of the availability of HPMS to users during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. EST. 98% 99% 99.5% 16 2008 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of complete unload processing of annual formulary submissions within 4 business days following due date. 99% 99% 99% 17 2009 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 90% 93% TBD 18 2009 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 19 2009 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1000 1200 TBD 20 2009 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% TBD 21 2009 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Percent of unload processing completed for annual bid submissions within 4 days following the due date. 98% 99% TBD 22 2009 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Service Availability Percent of time the daily 1-800-Medicare complaints file is loaded within 2 hours of receipt. 93% 95% TBD 23 2009 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of time that HPMS list serv emails are launched within one hour of receipt from CMS. 75% 80% TBD 24 2010 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 93% 95% TBD 25 2010 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 26 2010 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1200 1300 TBD 27 2010 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% TBD 28 2011 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 95% 96% TBD 29 2011 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 30 2011 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1300 1350 TBD 31 2011 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% TBD 32 2012 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 96% 97% TBD 33 2012 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 34 2012 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1350 1400 TBD 35 2012 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% TBD 36 2013 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 97% 98% TBD 37 2013 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 38 2013 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1400 1450 TBD 39 2013 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% TBD 40 2014 S.O. 1.2 - Increase health care service availability and accessibility Mission and Business Results Health Care Administration Percent of MA and PDP contracts approved in HPMS during the annual contracting cycle. 98% 99% TBD 41 2014 S.O. 1.2 - Increase health care service availability and accessibility Customer Results Response Time Percent of HPMS help desk inquiries completed within 24 hours. 99% 99% TBD 42 2014 S.O. 1.2 - Increase health care service availability and accessibility Processes and Activities Efficiency Increase the maximum number of plan bid submissions processed within 24 hours of receipt. 1450 1500 TBD 43 2014 S.O. 1.2 - Increase health care service availability and accessibility Technology Availability Percent of HPMS system availability during normal business hours, at a minimum from 6:00 a.m. EST to 10:00 p.m. ET. 99% 99% 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 Plan Enrollment (Health Plan Management System)
- 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 HPMS Meta Data Management Services Data Management Meta Data Management No Reuse 25 2 HPMS Data Warehouse Services Data Management Data Warehouse No Reuse 25 3 HPMS Contact and Profile Management Services Customer Relationship Management Contact and Profile Management 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 Meta Data Management Service Platform and Infrastructure Database / Storage Database Oracle by: TBD 2 Meta Data Management Service Platform and Infrastructure Delivery Servers Web Servers Microsoft Windows 2000 by: Microsoft Corporation 3 Data Warehouse Service Platform and Infrastructure Delivery Servers Web Servers Microsoft Windows 2000 by: Microsoft Corporation 4 Data Warehouse Service Access and Delivery Delivery Channels Internet Windows Internet Explorer by: Microsoft Corporation 5 Data Warehouse Service Platform and Infrastructure Database / Storage Database Oracle by: Oracle Corporation 6 Contact and Profile Management Service Access and Delivery Delivery Channels Internet Windows Internet Explorer by: Microsoft Corporation 7 Contact and Profile Management Service Platform and Infrastructure Delivery Servers Web Servers Microsoft Windows 2000 by: Microsoft Corporation 8 Contact and Profile Management Service Platform and Infrastructure Database / Storage Database Oracle by: Oracle Corporation
- 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?
- 2008-02-15
- 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?
- The system is meeting its performance objectives and the needs of stakeholders are being met. The investment is continually analyzed to ensure continuous service as the provisions of MMA are implemented.





