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[Status report on agreement between AHCCCS and the State of Hawaii using (PMMIS)] :: Arizona State Government Publications
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[Status report on agreement between AHCCCS and the State of Hawaii using (PMMIS)]
Ourfirst care is your health care
The Honorable Timothy S. Bee, President
The Honorable James P. Weiers
Arizona House ofRepresentatives
Chairman ofthe Senate Appropriations Committee
Chairman ofthe House Appropriations Committee
801 East Jefferson, PhoenixAZ85034
PO Box 25520, Phoenix AZ85002
Phone 602- 417- 4000
www. azahcccs. gov
RECEI\/ ED
Dear President Bee, Speaker Weiers and Chairmen Burns and Pearce:
Pursuant to A. R. S. § 36- 2925. subsection H, AHCCCS is submitting this status report on the
agreement between AHCCCS and the State of Hawaii for data processing activities using the
AHCCCS Prepaid Medicaid Management Information System ( PMMIS).
This report summarizes the financial and operational activities for the current Interstate
Agreement ( ISA 3) between AHCCCS and the Med- QUEST Division/ Department of Human
Services for Hawaii which began in 1999. The prior two ISAs have been completed and have
been recapped in prior reports.
The seven major " phases" of ISA 3 are as follows:
1. Design, Development and Implementation of the PMMIS Managed Care Module
2. Design, Development and Implementation of the Fee- For- Service Module
3. Provision of Ongoing Hawaii Operations and Maintenance Support
4. Hawaii- Arizona Health Insurance Portability and Accountability Act of 1996 ( HIPAA
Implementation) including the development and implementation of the National Provider
Identifier ( NPI) requirements
5. Design, Development and Implementation ofthe Executive Information System/ Decision
Support System ( EIS/ DSS)
6. Design, Development and Implementation of Medicaid Information Technology
Architecture ( MITA)
7. Design, Development and Implementation ofHIPAA Standards, Second Generation.
The following briefly recaps the operational activities of each of the phases along with the
revenue and expenditure activity for Fiscal Year 2008.
In accordance with A. R. S. § 36- 2927 Intergovernmental Services Funds have been set up to
deposit the monies received from Hawaii and to account for the expenditures that are incurred on
its behalf. The attached Chart 1 summarizes the revenues and expenditures ofmonies from these
funds for Fiscal Year 2008.
Design, Development and Implementation - Managed Care
This phase began in November 1999 and was implemented by Hawaii in December 2000. Its
purpose was to modify the Arizona PMMIS system to allow for the processing of Hawaii
information as well as upgrading and updating AHCCCS' system to accommodate new federal
Design, Development and Implementation - Fee- For- Service
This phase began in June 2001 and was implemented in November of 2002, The purpose ofthis
phase was to design, develop, and implement enhancements to the claims processing module as
well as modifications to the existing managed care functionality ofPMMIS for Hawaii's use.
Ongoing Hawaii Operations and Maintenance Support
Once PMMIS went live in Hawaii, Arizona began providing ongoing operations and
maintenance for the system. Hawaii is charged for work done by Arizona Information
Technology ( IT) staff and independent contractors, a designated percentage of other specified
AHCCCS personnel in IT, direct Hawaii costs, and a portion of AHCCCS indirect operating
costs which benefit the project.
Hawaii- Arizona HIPAA
Hawaii and Arizona had a joint Advanced Planning Document ( APD) for both States to perform
, the activities necessary to implement the Health Insurance Portability and Accountability Act of
1996 ( HIPAA) requirements at a mixture of federal financial participation rates. The APD
amount was for · $ 5,217, 211 for Hawaii expenditures paid locally here in Arizona and $ 8,512,304
for Arizona costs. Fiscal Year 2008 Arizona expenditures totaled $ 599,194 which equates to
$ 71,203 in State funds due to the various federal fund matches and this APD was closed in June.
Hawaii- Arizona NPI
In September of 2006 the states received approval of a joint Implementation Advance Planning
Document ( IAPD) from CMS for enhanced funding towards modification of their Medicaid
Management Information Systems to come into compliance with the National Provider Identifier
( NPI) requirements of HIPAA. The IAPD approved an Arizona total computable budget of
$ 1,152,044 and a Hawaii total computable budget of $ 980,650 of which $ 756,250 was allocated
for Hawaii expenditures to be paid from Arizona. For Fiscal Year 2008, Arizona expenditures
totaled $ 192,235, of which, $ 19,223 were State funds. This brought the total funds expended in
this project to $ 278,936 or $ 27,894 in State funds.
Arizona- Hawaii EISIDSS ( Executive Information SystemlDecision Support System)
Phase I of the EIS/ DSS Advanced Planning Document was approved for Arizona in 2004. This
was to design, develop and implement an Executive Information System/ Decision Support
System which would develop a more efficient way to extract information requested. An APDU
was approved in 2005 which was for an updated project implementation schedule and an
adjustment to project costs to reflect actual costs in the contract awarded to EDS ( Electronic
Data Systems) for developing and implementing the DSS. A further APDU was approved in
2006 to include additional funds as well as $ 50,000 for a requirements analysis for Hawaii. In
April of 2008, another APDU was approved to reflect Phase III of the project bringing Hawaii's
total approval to $ 1,470,000 ($ 1,390,000 to be paid from Arizona) and the Arizona total
computable budget to $ 5,698, 190. For Fiscal Year 2008 Arizona expenditures for Phases 1 and
II were $ 76,749 ( State share of $ 7,675) and $ 39,379 ( State share of $ 5,138) for Phase III.
Arizona- Hawaii MITA ( Medicaid Information Technology Architecture)
During 2008, Arizona and Hawaii received approval from CMS to prepare a Planning Advance
Planning Document ( PAPD) to perform a Medicaid Information Technology Architecture
( MITA) State Self- Assessment. This process was to promote improvements in Medicaid
information technology planning on a program- wide or enterprise- wide level. This PAPD would
allow the states to document current business processes, map them to the appropriate MITA
capability and maturity matrices and begin development of a MITA Transition Plan. A total of
$ 1,600,000 in total computable costs was approved ($ 800,000 for each state). For FY2008,
Arizona expended $ 59,000 in total computable costs for a State share of $ 5,900.
Arizona- Hawaii IDPAA Standards, Second Generation
In May 2008, Arizona and Hawaii received approval for a PAPD to begin planning and
assessment activities related to the adoption of the next mandated versions of the electronic
Transaction and Code Set ( TCS) standards under the Health Insurance Portability and
Accountability Act of 1996 ( HIPAA). This included the impact and requirements analysis
related to design, development and implementation of enhancements to the Medicaid
Management Information System ( MMIS) to implement these standards. The approvals were
$ 1,075,466 total computable for Arizona and $ 607,213 total computable for Hawaii based on a
mixture ofFFP percentages. No expenditures were made during FY08 so we will report more on
this in next year's letter.
HAPA Savings
Because ofthe HAPA project, Arizona has benefited through obtaining enhanced funding as well
as the sharing of both direct and indirect costs. A separate fund was set up to capture the dollars
attributed to the savings/ benefits achieved because ofthe project. The Fiscal Year 2008 fmancial
activities ofthis fund ( Fund 2439) are illustrated on Chart 1A.
In FY2009, the agency plans on spending revenues generated and a portion of the fund balance
for critical technology equipment replacements and programming for projects such as HIPAA 2nd
Generation, MITA, NPI, ACE, Imaging, Business Continuity, Virtual Office and the Decision
Support System. By utilizing this fund, we are able to lessen expenditures from the General
Fund in an ongoing effort to reduce expenditures due to continued budget constraints.
Additionally, we anticipate part of the savings in the account will be given to the State to help
with the budget shortfall.
We continue with ongoing operations and maintenance work as well as working on all the other
projects as indicated above. Both states continue to work cooperatively and both benefit by
improving business knowledge and processes, efficiencies, as well as a stronger infrastructure.
Hawaii continues to share in the costs of modifications to the majority of subsystems as well as
certain other expenditures which result in a reduction of costs to AHCCCS. This has enabled
AHCCCS to maintain the level of service required for our increasing membership along with
making Federal and State mandated system requirements with less contribution from the General
Fund than would otherwise been necessary.
Everyone remains pleased with the results of the project. Arizona has been able to receive
enhanced funding from CMS for many of its information technology activities as well as share
the maintenance and development of PMMISIHPMMIS hardware and software costs. We
continue to share ideas, methodologies and strategies and believe this is a good model for
potential future partnerships for other state joint ventures.
If you have any questions, please feel free to contact me at ( 602) 417- 4776.
lrector/ Chief Information Officer
C. James Apperson, Director, Governor's Office of Strategic Planning and Budgeting
Bret Cloninger, Analyst, Governor's Office of Strategic Planning and Budgeting
AHCCCS Hawaii Intergovernmental Service Funds
Revenues/ Expenditures and Fund Balance
Revenues/ Expenditures
Fund 2439- HAPA Savings
Indirect Transfers In*
Personal Services & ERE**
$ 263,076
Beginning Fund Balance FY 2008 $
Expenditures in Excess of Revenues
Salary & ERE
Other Professional & Outside Services
Travel - In- State
External Programming - Mainframe
Ending Fund Balance FY 2008 $ == 1,= 72==: 4=, 1= 51= 1
Expenditures in Excess of Revenues $ =====( 4= 4= 6:=, 6=: 5= 5=)
* Designated AHCCCS Operating Costs which are allocated and charged to Hawaii
** Portion of employees' salaries representing work done on the HAPA project charged back to Hawaii
Fund 2442- ISA # 3 ( DOl, Ongoing, HIPAA, NPI, DSS)
Revenues/ Expenditures Fund Balance
Advanced from HI for expenditures
Interest earned on HI fund balance
$ 8,137,454 8137454 Beginning Fund Balance FY 2008 $
41,105 41105.05
8,178,559 Expenditures in Excess of Revenues
( 319,181)
Expendituras
Personal Services & ERE
External Programming- Mainframe
Internal Service- Data Processing
Capital & Non Capital Equipment
2,983,569
Ending Fund Balance FY 2008 $ 1,172,502
8,497,740
Expenditures in Excess of Revenues $ =====( 3= 1= 9=, 1= 8::: 1=)
12/ 22/ 2008 3: 01 PM
Note: This fund is comprised of deposits from
Hawaii and is to be used for Hawaii's share of
PMMIS and other expenditures.
FY08 RevExp Chart for Annual Report ( 2). xls Annual Activity
TITLE [Status report on agreement between AHCCCS and the State of Hawaii using (PMMIS)]
SUBJECT Arizona Health Care Cost Containment System; Hawaii-- Dept. of Human Services-- Med-QUEST Division; Health services administration--Arizona--Data processing; Health services administration--Hawaii--Data processing; Medicaid--Claims administration--Arizona;
Source Identifier HCC 1.2:H 18
Location ocn432341363
DESCRIPTION 5 pages (PDF version). File size: 255.312 KB.
DATE ORIGINAL 2008-12-22
DIGITAL IDENTIFIER RMD_SENATE_AHCCS_DEC222008.pdf
File Size 5 pages (PDF version). File size: 255.312 KB.
Full Text , AHCCCS Ourfirst care is your health care ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM December 22, 2008 The Honorable Timothy S. Bee, President Arizona State Senate 1700 W. Washington Phoenix, AZ 85007 The Honorable James P. Weiers Speaker of the House Arizona House ofRepresentatives 1700 W. Washington Phoenix, AZ 85007 The Honorable Robert Burns Chairman ofthe Senate Appropriations Committee Arizona State Senate 1700 W. Washington Phoenix, AZ 85007 The Honorable Russell Pearce Chairman ofthe House Appropriations Committee Arizona House ofRepresentatives 1700 W. Washington Phoenix, AZ 85007 Janet Napolitano, Governor Anthony D. Rodgers, Director 801 East Jefferson, PhoenixAZ85034 PO Box 25520, Phoenix AZ85002 Phone 602- 417- 4000 www. azahcccs. gov RECEI\/ ED OFFICE OF THE PRESIDENT Dear President Bee, Speaker Weiers and Chairmen Burns and Pearce: Pursuant to A. R. S. § 36- 2925. subsection H, AHCCCS is submitting this status report on the agreement between AHCCCS and the State of Hawaii for data processing activities using the AHCCCS Prepaid Medicaid Management Information System ( PMMIS). This report summarizes the financial and operational activities for the current Interstate Agreement ( ISA 3) between AHCCCS and the Med- QUEST Division/ Department of Human Services for Hawaii which began in 1999. The prior two ISAs have been completed and have been recapped in prior reports. The seven major " phases" of ISA 3 are as follows: 1. Design, Development and Implementation of the PMMIS Managed Care Module 2. Design, Development and Implementation of the Fee- For- Service Module 3. Provision of Ongoing Hawaii Operations and Maintenance Support 4. Hawaii- Arizona Health Insurance Portability and Accountability Act of 1996 ( HIPAA Implementation) including the development and implementation of the National Provider Identifier ( NPI) requirements 5. Design, Development and Implementation ofthe Executive Information System/ Decision Support System ( EIS/ DSS) 6. Design, Development and Implementation of Medicaid Information Technology Architecture ( MITA) 7. Design, Development and Implementation ofHIPAA Standards, Second Generation. The following briefly recaps the operational activities of each of the phases along with the revenue and expenditure activity for Fiscal Year 2008. In accordance with A. R. S. § 36- 2927 Intergovernmental Services Funds have been set up to deposit the monies received from Hawaii and to account for the expenditures that are incurred on its behalf. The attached Chart 1 summarizes the revenues and expenditures ofmonies from these funds for Fiscal Year 2008. Design, Development and Implementation - Managed Care This phase began in November 1999 and was implemented by Hawaii in December 2000. Its purpose was to modify the Arizona PMMIS system to allow for the processing of Hawaii information as well as upgrading and updating AHCCCS' system to accommodate new federal reporting requirements. Design, Development and Implementation - Fee- For- Service This phase began in June 2001 and was implemented in November of 2002, The purpose ofthis phase was to design, develop, and implement enhancements to the claims processing module as well as modifications to the existing managed care functionality ofPMMIS for Hawaii's use. Ongoing Hawaii Operations and Maintenance Support Once PMMIS went live in Hawaii, Arizona began providing ongoing operations and maintenance for the system. Hawaii is charged for work done by Arizona Information Technology ( IT) staff and independent contractors, a designated percentage of other specified AHCCCS personnel in IT, direct Hawaii costs, and a portion of AHCCCS indirect operating costs which benefit the project. Hawaii- Arizona HIPAA Hawaii and Arizona had a joint Advanced Planning Document ( APD) for both States to perform , the activities necessary to implement the Health Insurance Portability and Accountability Act of 1996 ( HIPAA) requirements at a mixture of federal financial participation rates. The APD amount was for · $ 5,217, 211 for Hawaii expenditures paid locally here in Arizona and $ 8,512,304 for Arizona costs. Fiscal Year 2008 Arizona expenditures totaled $ 599,194 which equates to $ 71,203 in State funds due to the various federal fund matches and this APD was closed in June. Hawaii- Arizona NPI In September of 2006 the states received approval of a joint Implementation Advance Planning Document ( IAPD) from CMS for enhanced funding towards modification of their Medicaid Management Information Systems to come into compliance with the National Provider Identifier ( NPI) requirements of HIPAA. The IAPD approved an Arizona total computable budget of $ 1,152,044 and a Hawaii total computable budget of $ 980,650 of which $ 756,250 was allocated for Hawaii expenditures to be paid from Arizona. For Fiscal Year 2008, Arizona expenditures totaled $ 192,235, of which, $ 19,223 were State funds. This brought the total funds expended in this project to $ 278,936 or $ 27,894 in State funds. Arizona- Hawaii EISIDSS ( Executive Information SystemlDecision Support System) Phase I of the EIS/ DSS Advanced Planning Document was approved for Arizona in 2004. This was to design, develop and implement an Executive Information System/ Decision Support System which would develop a more efficient way to extract information requested. An APDU was approved in 2005 which was for an updated project implementation schedule and an adjustment to project costs to reflect actual costs in the contract awarded to EDS ( Electronic Data Systems) for developing and implementing the DSS. A further APDU was approved in 2006 to include additional funds as well as $ 50,000 for a requirements analysis for Hawaii. In April of 2008, another APDU was approved to reflect Phase III of the project bringing Hawaii's total approval to $ 1,470,000 ($ 1,390,000 to be paid from Arizona) and the Arizona total computable budget to $ 5,698, 190. For Fiscal Year 2008 Arizona expenditures for Phases 1 and II were $ 76,749 ( State share of $ 7,675) and $ 39,379 ( State share of $ 5,138) for Phase III. Arizona- Hawaii MITA ( Medicaid Information Technology Architecture) During 2008, Arizona and Hawaii received approval from CMS to prepare a Planning Advance Planning Document ( PAPD) to perform a Medicaid Information Technology Architecture ( MITA) State Self- Assessment. This process was to promote improvements in Medicaid information technology planning on a program- wide or enterprise- wide level. This PAPD would allow the states to document current business processes, map them to the appropriate MITA capability and maturity matrices and begin development of a MITA Transition Plan. A total of $ 1,600,000 in total computable costs was approved ($ 800,000 for each state). For FY2008, Arizona expended $ 59,000 in total computable costs for a State share of $ 5,900. Arizona- Hawaii IDPAA Standards, Second Generation In May 2008, Arizona and Hawaii received approval for a PAPD to begin planning and assessment activities related to the adoption of the next mandated versions of the electronic Transaction and Code Set ( TCS) standards under the Health Insurance Portability and Accountability Act of 1996 ( HIPAA). This included the impact and requirements analysis related to design, development and implementation of enhancements to the Medicaid Management Information System ( MMIS) to implement these standards. The approvals were $ 1,075,466 total computable for Arizona and $ 607,213 total computable for Hawaii based on a mixture ofFFP percentages. No expenditures were made during FY08 so we will report more on this in next year's letter. HAPA Savings Because ofthe HAPA project, Arizona has benefited through obtaining enhanced funding as well as the sharing of both direct and indirect costs. A separate fund was set up to capture the dollars attributed to the savings/ benefits achieved because ofthe project. The Fiscal Year 2008 fmancial activities ofthis fund ( Fund 2439) are illustrated on Chart 1A. In FY2009, the agency plans on spending revenues generated and a portion of the fund balance for critical technology equipment replacements and programming for projects such as HIPAA 2nd Generation, MITA, NPI, ACE, Imaging, Business Continuity, Virtual Office and the Decision Support System. By utilizing this fund, we are able to lessen expenditures from the General Fund in an ongoing effort to reduce expenditures due to continued budget constraints. Additionally, we anticipate part of the savings in the account will be given to the State to help with the budget shortfall. Project Summary We continue with ongoing operations and maintenance work as well as working on all the other projects as indicated above. Both states continue to work cooperatively and both benefit by improving business knowledge and processes, efficiencies, as well as a stronger infrastructure. Hawaii continues to share in the costs of modifications to the majority of subsystems as well as certain other expenditures which result in a reduction of costs to AHCCCS. This has enabled AHCCCS to maintain the level of service required for our increasing membership along with making Federal and State mandated system requirements with less contribution from the General Fund than would otherwise been necessary. Everyone remains pleased with the results of the project. Arizona has been able to receive enhanced funding from CMS for many of its information technology activities as well as share the maintenance and development of PMMISIHPMMIS hardware and software costs. We continue to share ideas, methodologies and strategies and believe this is a good model for potential future partnerships for other state joint ventures. If you have any questions, please feel free to contact me at ( 602) 417- 4776. lrector/ Chief Information Officer C. James Apperson, Director, Governor's Office of Strategic Planning and Budgeting Bret Cloninger, Analyst, Governor's Office of Strategic Planning and Budgeting Richard Stavneak, Director, Joint Legislative Budget Committee AHCCCS Hawaii Intergovernmental Service Funds Revenues/ Expenditures and Fund Balance Fiscal Year 2008 Chart 1 Chart 1A Revenues/ Expenditures Fund 2439- HAPA Savings Fund Balance Revenues Indirect Transfers In* Personal Services & ERE** $ 263,076 392,763 655,839 Beginning Fund Balance FY 2008 $ Expenditures in Excess of Revenues 2,170,805 ( 446,655) Expenditures Salary & ERE Other Professional & Outside Services Travel - In- State External Programming - Mainframe Repair & Maintenance Software Support & Maintenance Capital Equipment Non Capital Equipment Operating Transfers 1,102,494 1,102,494 Ending Fund Balance FY 2008 $ == 1,= 72==: 4=, 1= 51= 1 Expenditures in Excess of Revenues $ =====( 4= 4= 6:=, 6=: 5= 5=) * Designated AHCCCS Operating Costs which are allocated and charged to Hawaii ** Portion of employees' salaries representing work done on the HAPA project charged back to Hawaii Chart 1B Fund 2442- ISA # 3 ( DOl, Ongoing, HIPAA, NPI, DSS) Revenues/ Expenditures Fund Balance Revenues Advanced from HI for expenditures Interest earned on HI fund balance $ 8,137,454 8137454 Beginning Fund Balance FY 2008 $ 41,105 41105.05 8,178,559 Expenditures in Excess of Revenues 1,491,683 ( 319,181) Expendituras Personal Services & ERE Professional & Outside Services External Programming- Mainframe Travel Internal Service- Data Processing Software Support & Maintenance Capital & Non Capital Equipment Indirect Cost Transfers Out Other 3,145,098 10,253 546,795 3,098 2,983,569 714,097 915,012 179,817 Ending Fund Balance FY 2008 $ 1,172,502 8,497,740 Expenditures in Excess of Revenues $ =====( 3= 1= 9=, 1= 8::: 1=) 12/ 22/ 2008 3: 01 PM Note: This fund is comprised of deposits from Hawaii and is to be used for Hawaii's share of PMMIS and other expenditures. FY08 RevExp Chart for Annual Report ( 2). xls Annual Activity
[Status report on agreement between AHCCCS and the State...