September 23, 2015 FL

Transcription

1 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Atlanta Regional Office 61 Forsyth Street, Suite 4T20 Atlanta, South Carolina DIVISION OF MEDICAID & CHILDREN'S HEALTH OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES September 23, 2015 FL Mr. Justin N. Senior Deputy Secretary for Medicaid Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 8 Tallahassee, FL Dear Mr. Senior: The Centers for Medicare & Medicaid Services (CMS) approves Florida's Implementation Advance Planning Document (IAPD) for the takeover and enhancement of the state's Medicaid Management Information System (MMIS) by a Fiscal Agent procured through a competitive process, and the replacement of the state's current Decision Support System (DSS). Florida will require the selected Fiscal Agent to fulfill a systems integrator function to bring together the MMIS, DSS, and additional Medicaid systems at their appropriate integration points. As described in the IAPD, Florida will contract with one vendor for MMIS enhancements and Fiscal Agent services, as well as for replacement of the DSS and systems integrator services. The state has identified two primary phases for this project. In the first phase, the selected contractor will take over the existing MMIS and design, develop, and implement a targeted set of enhancements. Simultaneously, the contractor will design, develop, and implement the replacement DSS. In the second phase - a longer timeframe set to occur over the life of the Fiscal Agent contract - Florida will continue to work with the contractor to ensure system enhancements reflect modular, "best of breed" components. Florida's current Fiscal Agent contract with Hewlett Packard Enterprise Services (HPES) expires on June 30, Per the IAPD, the initiation phase for the MMIS takeover with enhancements and DSS replacement project will begin in January The state plans for an initial 18-month Design, Development, and Implementation (DDI) period. Operations for both the MMIS under the new Fiscal Agent contract and the replacement DSS will commence on July 1, Florida anticipates that the operations phase for both the MMIS and DSS will run through the projected end of the Fiscal Agent contract on June 30, During the operations phase of the MMIS, the Fiscal Agent and state will continue to upgrade the core MMIS and replace subsystems via competitive procurement. Florida must ensure that system maturity aligns with the Medicaid Information Technology Architecture (MITA) 3.0 framework and the state's completed MITA 3.0 State Self-Assessment. Through the DDI and operations phases, the MMIS and DSS must also adhere to the Seven Standards and Conditions for enhanced funding, including the requirement for loosely-coupled modules.

2 Mr. Justin N. Senior, Page 2 On December 24, 2014, CMS approved Planning Advance Planning Document-Update (PAPD-U) FL for Florida' s MMIS and DSS replacement project. Under the PAPD-U, approved planning funds totaled $28,249,407, with federal financial participation (FFP) of $25,539,761. In the IAPD, Florida requests to carry forward $11,760,760 in funding authorized under the PAPD-U. With approval of this IAPD, the state' s PAPD-U is officially closed, and funding authority under the PAPD-U is terminated. The IAPD is approved by CMS in accordance with Section 1903( a)(3) of the Social Security Act, 42 CFR 433, subpart C, 45 CFR 95, subpart F, and the State Medicaid Manual, Part 11. CMS approves new funding in the amount $60,078,154, with FFP of $52,672,468. Adding these amounts to the planning funds carried forward from the PAPD-U establishes a total project budget of$71,838,914, with $62,979,023 in FFP, as noted in Appendix A. Funding under the IAPD will expire on September 30,. The amounts shown in Appendix A cannot be reallocated between federal fiscal years, even within the period of this letter's approval, without the submission and approval of an IAPD-Update. This letter supersedes CMS' previous P APD approval letters for Florida' s MMIS and DSS replacement project. Onsite reviews may be conducted to assure that the intentions for which FFP was approved are being accomplished. Specifically, the objective is to validate that automated data processing (ADP) equipment or services are being efficiently and effectively utilized to support the approved programs or projects as provided under 45 CFR and the State Medicaid Manual. As provided by the State Medicaid Manual Section and by 45 CFR , all subsequent revisions and amendments to the IAPD will require CMS prior written approval to qualify for FFP. Only actual costs incurred are reimbursable. The state must provide adequate support for all costs claimed in addition to providing detailed records and proper audit trails. As described in regulation at 45 CFR and the State Medicaid Manual Section 11200, Requests for Proposals (RFPs) or contracts that the state procures with funding from the approved IAPD must be approved by CMS prior to release of the RFP or prior to execution of the contract. Failure to comply with prior approval requirements may result in either ineligibility for the enhanced federal match or disallowance for those activities. If there are any questions concerning this information, please contact John Allison at (828) or via at John.Allison@cms.hhs.gov. Sincerely, Enclosure Jackie Glaze Associate Regional Administrator Division of Medicaid & Children' s Health Operations

3 Approved through DOI APD ;m; m.. H.. Appendix A:. MMIS Detailed Budget Table Covers FFY s , ending September 30, Note: The amounts provided for FFY 2014 reflect state-reported expenditures, and are for informational purposes only. MMlSCMS Share Share Share MMIS (90% FFP) (10%) (75% FFP) (25%) (50% FFP) (50%) FUNDJNG,_,. FFPTotal,11,~ J!:;. '"' 2A 2At -- 2At -- 2At -- FFY 2014 $0 $0 $0 $0 $0 $0 $0 $0 FFY 2015 $0 $0 $0 $0 $118,960 $118,960 $118,960 $118,960 FFY 2016 $36,000 $4,000 $0 $0 $207,890 $207,890 $243,890 $211,890 FFY 2017 $1, 135,012 $126,112 $0 $0 $300,723 $300,723 $1,435,735 $426,835 FFY 2018 $1,464,791 $162,755 $0 $0 $1,392,428 $1,392,428 $2,857,219 $1,555,183 FFY $659,556 $73,284 $0 $0 $75,000 $75,000 $734,556 $148,284 FFYs $3,295,359 $366,151 $0 $0 $2,095,001 $2,095,001 $5,390,360 $2,461, 152 Approved through DOI APD MMlSCMS Share State Sbate Share Share MMlS (90%FFP) (10%) (75%FFP) (25%) (50%FFP) (50%) FUNDING om).. 2B 2Bt 2Bt Bt -- FFY 2014 $137,088 $15,232 $0 $0 $0 $0 $137,088 $15,232 FFY 2015 $3,777,512 $419,724 $0 $0 $0 $0 $3,777,512 $419,724 FFY 2016 $4,467,539 $496,393 $0 $0 $0 $0 $4,467,539 $496,393 FFY 2017 $22,743,999 $2,527, 111 $0 $0 $0 $0 $22,743,999 $2,527, 111 FFY 2018 $24,295,027 $2,699,447 $0 $0 $0 $0 $24,295,027 $2,699,447 FFY $2, 167,498 $240,833 $0 $0 $0 $0 $2,167,498 $240,833 FFYs $57,588,663 $6,398,740 $0 $0 $0 $0 $57,588,663 $6,398,740

4 M&O M&O Share Share MMIS (75% FFP) (25%) (75% FFP) (25%) ENHANCED FUNDING 75% 4Bt 4At FFY 2014 $0 $0 $0 $0 $0 $0 FFY 2015 $0 $0 $0 $0 $0 $0 FFY 2016 $0 $0 $0 $0 $0 $0 FFY 2017 $0 $0 $0 $0 $0 $0 FFY 2018 $0 $0 $0 $0 $0 $0 FFY $0 $0 $0 $0 $0 $0 FFYs $0 $0 $0 $0 $0 $0 Share Share Share MMIS (50%FFP) (50%) (50%FFP) (50%) (50%FFP) (50%) ENHANCED FUNDING 50% 5At 5Bt 5Ct FFY 2014 $0 $0 $0 $0 $0 $0 $0 $0 FFY 2015 $0 $0 $0 $0 $0 $0 $0 $0 FFY 2016 $0 $0 $0 $0 $0 $0 $0 $0 FFY 2017 $0 $0 $0 $0 $0 $0 $0 $0 FFY 2018 $0 $0 $0 $0 $0 $0 $0 $0 FFY $0 $0 $0 $0 $0 $0 $0 $0 FFYs $0 $0 $0 $0 $0 $0 $0 $0

5 MMlSCMS MMlSCMS Share Share Share M'i + +a "' 2A&Bt -- 4A&Bt -- 5A,B&Ct -- TOTAL FFP STATE SHARE TOTAL FFY 2014 $137,088 $15,232 $0 $0 $0 $0 $137,088 $15,232 FFY 2015 $3,896,472 $538,684 $0 $0 $0 $0 $3,896,472 $538,684 FFY 2016 $4,711,429 $708,283 $0 $0 $0 $0 $4,711,429 $708,283 FFY 2017 $24, 179,734 $2,953,946 $0 $0 $0 $0 $24,179,734 $2,953,946 FFY 2018 $27,152,246 $4,254,630 $0 $0 $0 $0 $27,152,246 $4,254,630 FFY $2,902,054 $389,117 $0 $0 $0 $0 $2,902,054 $389, 117 FFYs20\4- $62,979,023 $8,859,892 $0 $0 $0 $0 $62,979,023 $8,859,892 APDTOTAL (TOTAL COMPU:f ABLE) $152,320 $4,435,156 $5,419,712 $27, 133,680 $31,406,876 $3,291, 171 $71,838,914 I tmbes Line Item 2A MMIS- Design, Development or Installation of MMIS: Cost of In-house Activities 28 MMIS- Design, Development or Installation of MMIS: Cost of Private Contractors 4A Operation Approved MMIS - Cost of In-House Activities 48 Operation Approved MMIS - Private Sector Contractors SA Mechanized Systems, Not Approved Under MMIS Procedures - Cost of In-House Activities 58 Mechanized Systems, Not Approved Under MMIS Procedures - Cost of Private Sector Contractors SC Mechanized Systems, Not Approved Under MMIS Procedures- Interagency FFP rates for specific MMIS activities and costs can be found at the State Medicaid Manual, Chapter 11, available at lations-and Guidance/Guid ance/manuals/paper-8 ased-manuals-ltems/cms html