Cover Oregon
Weekly status report covering week 3
For week ending May 30, 2014
Transition Project Director: Tina Edlund
Senior Project Manager: Sarah Miller
Submitted by: Deloitte Consulting
Submission Date: June 2, 2014
Version 1
Executive Summary
Overall Status
Transition
QHP to FFM:
G
On Track
Support MAGI
Medicaid:
R
At Risk
Rationale: Lack of direct access to OHA & Cover Oregon development/test
environments through the end of Week 3 of the assessment, is negatively impacting
available time for Deloitte to make feasible assessment of OHA system current state
and re-usability of Cover Oregon functionality for MAGI Medicaid.
Key Accomplishments
• Submitted Deliverable 3 – Status Report for Week 2
• Submitted Deliverable Expectations Documents for: Web Presence, Security Strategy, Organizational Change Management
• Reviewed key financial rules for MAGI Medicaid Children’s Health Insurance Programs (MAGI Medicaid/CHIP) and documented
gaps in the current Cover Oregon rule set
• Continued daily session with the team leads and approach alignment session with the team leads and Business Lead
• Coordinated End to End User Process Flow session
Key Next Steps
• Submit the finalized set of 26 key MAGI Medicaid/CHIP scenarios to the Eligibility & Enrollment (EE) team for review and feedback
• Complete internal review of recommendations for all verification services
• Complete review of use cases, process flows and requirements with Modified Adjusted Gross Income (MAGI) Medicaid project
stakeholders
• Validate the draft security requirements and prioritize for Nov. 2014
• Analyze and review canned reporting requirements for minimum Affordable Care Act (ACA) compliance for Nov. 2014 [CMS and
Determination State]
Key Issues/Risks
• Lack of direct access to OHA development/test environments through the end of Week 3 of the assessment, is negatively
impacting available time for Deloitte to make feasible assessment of OHA system current state
• State counterpart for Organization Change Management will not be on-boarded until June 3
• Oracle contract scheduled to end on June 15, we need to assess whether this will have an impact of this relative to the overall
scope
Status Report for week ending May 30, 2014
1
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Cover Oregon – Status Report Dashboard
#
Week ending May 30, 2014
%
Complete
Key Deliverables
Completion
Date
Sign-Off
Date
Status
Workstream #1: Project Management
1.1
Project approach and staffing plan
100%
May 14, 2014
May19, 2014
G
1.2
Weekly status report covering week 1
100%
May 19, 2014
May 22, 2014
G
1.3
Weekly status report covering week 2
100%
May 26, 2014
May 29, 2014
G
1.4
Weekly status report covering week 3
90%
June 2, 2014
June 5, 2014
G
1.5
Weekly status report covering week 4
0%
June 9, 2014
June 12, 2014
N
1.6
Weekly status report covering week 5
0%
June 16, 2014
June 19,2014
N
1.7
Final status report covering weeks 1-6
0%
June 20, 2014
June 25, 2014
N
10%
June 20, 2014
June 25, 2014
G
Workstream #2: Transition QHP to FFM
2.1
QHP to FFM Roadmap
Workstream #3: Support MAGI Medicaid
3.1
Web Presence Strategy
In Progress
June 18, 2014
June 23, 2014
G
3.2
Security Strategy
In Progress
June 18, 2014
June 23, 2014
3.3
Organization Change Mgmt (OCM) Strategy
Started
June 18, 2014
June 23, 2014
3.4
Requirements Catalog
20%
June 18, 2014
June 23, 2014
R
R
Y
3.5
MAGI Medicaid Roadmap
20%
June 20, 2014
June 25, 2014
Y
% Complete
Legend
Status
Legend
N
0% - Not Started
50% - Half-way Complete
90% - Submitted for Approval
10% - Started
70% - Well Underway
100% - Complete / Approved
20% - In Progress
80% - Submitted for Review
Not Started
G
On Track
Status Report for week ending May 30, 2014
Y
Needs attention
2
R
At risk of meeting timelines
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Cover Oregon – Status Report Dashboard
#
Week ending May 30, 2014
Key Activities
%
Complete
Status
100%
G
Workstream #1: Project Management
1
Definition of Project methodology, Project management approach, and anticipated staffing for activities
within this SOW
2
Planning, coordination, and weekly status reporting of activities within this SOW
On-going
G
3
Daily oral briefings with Cover Oregon’s Contract Administrator
On-going
G
20%
G
Workstream #2: Transition QHP to FFM
1
Development of a strategy roadmap for transitioning individual enrollment for Qualified Health Plans to
Federally Facilitated Marketplace
Workstream #3: Support MAGI Medicaid
1
Scoping and recommendation of a strategy for interfaces
20%
R
2
Comparison of data models
20%
Y
3
Requirements clarification and catalog update
20%
R
4
Development of a strategy for the web presence for the Medicaid Eligibility System Front End
10%
5
Hub On-Boarding Work & Bi-Directional Account Transfer Initiation Work
20%
Y
Y
6
Complete a Security Assessment/Establish Security Strategy
10%
R
7
Establish scope for organizational change management and training
0%
N
8
Establish scope for all types of testing
20%
Y
9
Contingency planning for subsequent work
0%
N
% Complete
Legend
Status
Legend
N
0% - Not Started
50% - Half-way Complete
90% - Submitted for Approval
10% - Started
70% - Well Underway
100% - Complete / Approved
20% - In Progress
80% - Submitted for Review
Not Started
G
On Track
Status Report for week ending May 30, 2014
Y
Needs attention
3
R
At risk of meeting timelines
Copyright © 2014 Deloitte Development LLC. All rights reserved.
Appendix
Status by Team
Leads: David F./Annamarie B
Status by Team
Workstream #1: Project Management Team
Accomplishments (prior week)
•
•
•
•
•
•
•
•
•
•
•
Executed daily oral briefings with Cover Oregon’s Contract Administrator
Facilitated daily session with the team leads
Facilitated approach alignment session with team leads and Business Lead
Coordinated End to End User Process Flow session
Submitted Oracle resource needs to the state to support the team in lieu of environment access
Coordinated Meeting schedule on SharePoint with State and Deloitte team leads
Submitted Deliverable Expectations Documents for: Web Presence, Security Strategy, Organizational Change
Management
Initiated consolidation of project plan
Coordinated remaining access gaps to State SharePoint site for all Deloitte resources
On-boarded three additional Deloitte resources (per plan) and State team leads
Prepared Deliverable 3 – Status Report for Week 3 for submission
Upcoming Work (current week)
•
•
•
•
Execute daily oral briefings with Cover Oregon’s Contract Administrator
Coordinate work plan updates with State PMO Lead
Coordinate conversion of Big Rocks issues tracker to SharePoint
Prepare Deliverable 4 – Status Report for Week 4 for submission
Issues/Risks
• Alternative approaches needs to be discussed to complete certain deliverables given lack of environment
access and early roll off of Oracle resources
Status Report for week ending May 30, 2014
5
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Leads: Chiqui F./Ivy B.
Status by Team
Workstream #2: QHP Transition to FFM Team
Accomplishments (prior week)
• Plan Management
• Updated transition work plan to include input from Cover Oregon and Oregon Insurance Division
• Continued follow-up with CMS to obtain response to list of 20 questions previously sent for clarification on May 27, 2014
• Conducted discovery of the transition implications to SHOP process
• Broker: Began discovery discussions with Broker/Agent contact to identify communication needs, business process changes
• Web based strategy – formulating
• Continued assessment of the Cover Oregon site to identify content needed to support the transition to Federally Facilitated Marketplace
(FFM)
• Continued reviewing other FFM state sites to identify ideas for Oregon’s home page
• Began defining the user work flows for the Cover Oregon information pages, MAGI (Modified Adjusted Gross Income) Medicaid, and the
FFM links
• Began reviewing available Portal solutions to support the MAGI Medicaid applications (Cover Oregon, Oregon Benefits Online, paper
application)
• Began discovery and analysis of technical architecture in OHA e-Government Portal for hosting the public facing website and OHA’s
Medicaid Application
Upcoming Work (current week)
• Plan Management
• Review answers to questions submitted to CMS to help us understand end-to-end process and begin defining gaps (TBD)
• Review and update draft work plan to define activities required between current date and Nov. 2014, target completion Wednesday
• Discuss communication tools/process with the carriers
• Broker
• Continue identifying impacts to Broker/Agent relationships with Carriers and clients
• Web based strategy – formulating
• Begin creating site map of future capabilities for Oregon’s home page and other pages based on ideas gathered from other states and
existing pages
• Continue assessment of the Cover Oregon site to identify content needed to support the transition to FFM
• Continue reviewing portal solutions to support MAGI Medicaid application (Cover Oregon, Oregon Benefits Online, paper applications…)
• Begin documenting critical success factors, assumptions and constraints – target execution date June 12
Issues/Risks
• Need state contact for Navigator track
Status Report for week ending May 30, 2014
6
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Leads: Carol B./Yer V./Stephanie R.
Status by Team
Workstream #3: Application Intake & Case Management Team
Accomplishments (prior week)
• Continued drafting of data crosswalk consisting of multiple system data fields and their respective alignments
to understand current flow and consistency of data across current applications
• Conducted requirements validation session and finalized prep material comprised of:
• use case descriptions for Application Intake & Case Management process areas
• process flows for Application Intake & Case Management process areas
• initial requirements catalog and gaps for Application Intake & Case Management process areas, based on
Cover Oregon and Oregon Health Authority (OHA) requirements documents, and categorized under following
areas: Application Registration and Application Intake, Change in Circumstances, Manual Redeterminations,
Complaints, Appeals and Hearings
Upcoming Work (current week)
•
•
•
•
Continue review of Cover Oregon and OHA Siebel application and available documentation
Review existing OHA application functionality by walking through selected end-to-end use cases
Complete development of requirements catalog
Complete review of use cases, process flows and requirements with Modified Adjusted Gross Income (MAGI)
Medicaid project stakeholders
• Validate the draft Application Intake & Case Management team requirements and prioritize for Nov. 2014
Issues/Risks
• Lack of direct access to OHA & Cover Oregon development/test environments through the end of Week 3 of
the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system
current state and re-usability of Cover Oregon functionality
Status Report for week ending May 30, 2014
7
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Leads: Joyce C./Vivian L./Praneet R.
Status by Team
Workstream #4: Eligibility & Enrollment Team
Accomplishments (prior week)
• Reviewed key financial rules for MAGI Medicaid Children’s Health Insurance Programs (MAGI Medicaid/CHIP) and documented
gaps in the current Cover Oregon ruleset
• Reviewed 15 key MAGI Medicaid/CHIP scenarios and updated based on the team’s feedback
• Conducted gap analysis to determine gaps in Cover Oregon Noticing requirements vs. Affordable Care Act (ACA) required notices
and came up with a list of must have noticing requirements for Nov. 2014
• Reviewed current Enrollment process and came up with a To-Be Enrollment process
• Cover Oregon/Oregon Health Authority (OHA) provided the current enrollment and noticing process to expedite our
understanding
• Continued to analyze the process of commenting out rules not related to MAGI Medicaid/CHIP in the current Cover Oregon
Ruleset
• Identified gaps in OHA data model vs. required data elements for eligibility determination and for storing eligibility determination
results
Upcoming Work (current week)
• Submit the finalized set of 26 key MAGI Medicaid/CHIP scenarios to the Eligibility & Enrollment (EE) team for
review and feedback
• Submit a draft version of Eligibility, Enrollment and Noticing requirements to the EE team for review and
feedback
• Submit a draft version of the To-Be Enrollment process to the EE team for review and feedback
• Review current noticing process flow and come up with a To-Be noticing process flow. Also, submit the finalized
To-be flow for team review and feedback
• Complete the analysis of the process of commenting out rules not related to MAGI Medicaid/CHIP in the
current Cover Oregon Ruleset
• Validate the draft Eligibility & Enrollment requirements and prioritize for Nov. 2014
Issues/Risks
• None
Status Report for week ending May 30, 2014
8
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Leads: Britt S./Sandeep C.
Status by Team
Workstream #5: Interfaces Team
Accomplishments (prior week)
• Completed mapping of State Modified Adjusted Gross Income (MAGI) validation plan to existing verification
services with current status of the implemented services & started internal review of the recommendations
• Continued building requirements catalog by incorporating the requirements from other states and Oregon HIX
documents
• Started review of the Account Transfer Extensible Markup Language (XML) structures for different scenarios
• Started review of the Minimum Essential Coverage (MEC) business service definition (BSD) and use case
scenarios
• Continued review of the Cover Oregon Siebel to Oregon Health Authority (OHA) Web Services to Medicaid
Management Information System (MMIS) interface to understand the data flow and current status of the
implementation
Upcoming Work (current week)
• Complete internal review of recommendations for all verification services
• Continue to build requirements catalog by incorporating the requirements from other states, Oregon HIX
documents and refine as needed
• Complete review of the Account Transfer XML structures for different scenarios
• Complete review of the MEC BSD and use case scenarios to refine requirements
• Continue to review the current process flow of Cover Oregon Siebel-OHA web service-MMIS interface to
identify the functionalities that require changes to implement end to end MMIS enrollment
• Validate the draft Interfaces team requirements and prioritize for Nov. 2014
Issues/Risks
• Lack of direct access to Cover Oregon development/test environments through the end of Week 3 of the
assessment, is negatively impacting available time for Deloitte to make feasible assessment of re-usability of
Cover Oregon verification interfaces
Status Report for week ending May 30, 2014
9
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Leads: Stefan R./Debi M.
Status by Team
Workstream #6: Security Team
Accomplishments (prior week)
• Continued to review the polices and procedure shared by Oregon Health Authority (OHA) Chief Information
Security Officer (CISO) office and security team in alignment with Center for Medicare and Medicaid Services
(CMS) security requirements and documented the shortcomings
• Participated in meetings / interviews with OHA security team and Oracle to understand the existing security
infrastructure and documented the gaps as per CMS requirements
• Participated in the initial call with CMS to identify the security deliverables and timelines in order to connect
with the Federally-Facilitated Marketplace (FFM) services
• Obtained access to Identity & Access Management (IAM) environments for UDEV/FTS in Cover Oregon
environment
• Submitted the Deliverable Expectation Document (DED) for security strategy deliverable as part of the current
assessment
Upcoming Work (current week)
• Continue to work with the CISO office and security team to complete the review of existing security policy and
procedures and document the findings
• Document the findings and gaps identified in the OHA security infrastructure in-comparison to CMS
requirements.
• Document the draft security roadmap for OHA MAGI Medicaid
• Validate the draft security requirements and prioritize for Nov. 2014
Issues/Risks
• Lack of direct access to OHA & Cover Oregon development/test environments through the end of Week 3 of
the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system
current state and re-usability of Cover Oregon functionality
Status Report for week ending May 30, 2014
10
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Leads: Rob T./Jeremy B.
Status by Team
Workstream #7: Solution Architecture & Infrastructure Team
Accomplishments (prior week)
• Coordinated with Oracle Cloud Management Services (OMCS) and Cover Oregon Security to determine process and
grant access to Cover Oregon application environments for Deloitte team analysis activities
• Coordinated with OMCS and Oracle Consulting Service (OCS) on Oregon Health Authority (OHA) Training environment
refresh in preparation for Deloitte team analysis activities
• Participated and provided input into the OHA Environment Strategy for the implementation phase
• Distributed OHA Siebel repository analysis report on customization and best practices to Rob, Peter, and Mark on 05/30
• Participated in follow-up Web Presence Security Strategy session to align potential solutions across multiple teams
• Provided initial recommendation on leveraging Cover Oregon Fed Integrations for reuse and determined next analysis
steps
Upcoming Work (current week)
• Conduct session to review to-be High Level Solution Architecture draft with Solution Architecture team
• Review to-be Integration Security Strategy with Security Team and State Security Architects
• Provide inputs on detailed analysis on leveraging Cover Oregon Fed Integrations for reuse in OHA in conjunction with
Security and Integration teams
• Develop refined Application Intake options in conjunction with Security, Application Intake, and Eligibility teams
• Address follow-up questions of OHA Siebel repository analysis report on customization and best practices
• Review and provide feedback into the Data Conversion strategy
• Finalize environment designation for Center for Medicare and Medicaid Services (CMS) Certificates for Hub Testing
including specific environments to be used for hub testing, both formal and informal
Issues/Risks
• Need access to Household Grouping design from OHA team to validate implications on assessment and inform
the MAGI Medicaid Roadmap deliverable
Status Report for week ending May 30, 2014
11
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Leads: David V./Dmitry K.
Status by Team
Workstream #8: Testing Team
Accomplishments (prior week)
•
•
•
•
•
Defined roles and responsibilities across the testing project team
Identified source of test data
Facilitated planning sessions to define scope for test environments
Significant progress made toward acquisition and configuration of test tools
Facilitated meeting with Track leads to estimate number of test scenario needed
Upcoming Work (current week)
•
•
•
•
Facilitate meeting for “come to agreement” about test environments
Initiate discussion with CO test team to review CO test data and test scenario
Facilitate discussion to define requirements for performance testing
Meet with the OIS team that manages Application Lifecycle Management (ALM) to discuss requirements for
use of ALM
• Make substantial progress on Testing Strategy document
• Meet with potential Section 508 testing resource
Issues/Risks
• None
Status Report for week ending May 30, 2014
12
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Leads: Chris B./Nancy R./Lali C.
Status by Team
Workstream #9: Reporting Team
Accomplishments (prior week)
•
•
•
•
•
•
Decision: Oregon Health Authority (OHA) database will be the only source for Reporting
Identified some of the Centers for Medicare & Medicaid Services (CMS) reporting needs
Received list of reports from Determination state (e.g. Montana)
Confirmed reporting scope buckets
Defined and reviewed the Approach for Reporting Assessment
Added Melissa Hanks to the Reporting Team
Upcoming Work (current week)
• Analyze and review canned reporting requirements for minimum Affordable Care Act (ACA) compliance for
Nov. 2014 [CMS and Determination State]
• Assess ad-hoc reporting requirements for minimum ACA compliance for Nov. 2014 [Consumer Information and
Insurance Oversight (CCIIO), Legislative and Operational]
• Follow up on Reporting Requirements documented in the Household Grouper Functional Design Document
with Oracle
• Validate the draft Reporting team requirements and prioritize for Nov. 2014
Issues/Risks
• Need access to Household Grouping design from OHA team to validate implications on assessment and inform
the MAGI Medicaid Roadmap deliverable
Status Report for week ending May 30, 2014
13
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Leads: Chris B./Nancy R./Lali C.
Status by Team
Workstream #10: Data Conversion Team
Accomplishments (prior week)
•
•
•
•
Participated in the data cross walk approach discussions
Defined and reviewed the approach for Data Conversion assessment
Initiated data elements identification on Data Conversion needs for Nov. 2014
Data model for Cover Oregon (to be delivered end of week by Oracle)
Upcoming Work (current week)
• Review data sources including application process for Data Conversion
• Confirm mandatory/conditional data elements from Federally Facilitated Marketplace (FFM) to Oregon Health
Authority (OHA) data model
• Identify additional data elements from Cover Oregon to OHA
• Assess the usability of data
• Finalize Data Conversion scope
• Participate in Application Interface, Eligibility and Data Conversion end to end review process
Issues/Risks
• Need access to Household Grouping design from OHA team to validate implications on assessment and inform
the Modified Adjusted Gross Income (MAGI) Medicaid Roadmap deliverable
• Delay in access to Cover Oregon and OHA environments coupled with the access to Oracle resources has
delayed the completion of Data mapping exercise; expected to be completed by end of week 4
Status Report for week ending May 30, 2014
14
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Leads: [client - TBD]/Jennifer M.
Status by Team
Workstream #11: Org Change Management Team
Accomplishments (prior week)
• Updated the drafted Deliverable Expectations Document for Organization Change Management (OCM)
Strategy
• Met with the client to discuss Cover Oregon’s communication channels, awareness campaign, and engagement
and outreach
• Identifying topics in which more information is needed in regards to 5503
• Began conversations to facilitate a site visit to 5503
• Prepared for Cover Oregon and Oregon Health Authority (OHA) staff interviews
Upcoming Work (current week)
•
•
•
•
•
Conduct a site visit to 5503
Meet with Kathleen P. and Judy M. P. to gain a broader understanding of the work done within 5503
Conduct Cover Oregon and OHA staff interviews
Consolidate notes from interviews
Begin documenting areas of focus for OCM based on developed business processes, identifying manual and
newly automated processes
Issues/Risks
• State counterpart will not be on-boarded until June 3
Status Report for week ending May 30, 2014
15
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