DEPARTMENT OF HEALTH & HUMAN SERVICES
Department of Health & Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mailstop C3-01-24
Baltimore, Maryland 21244-1850
Office of Financial Management
MEMORANDUM
DATE: March 17, 2005
TO: Center and Office Directors
Regional Administrators
/s/ Tim Hill
FROM: Timothy B. Hill
Director
Office of Financial Management
SUBJECT: Integrated Budget Call: Fiscal Year (FY) 2006 Operating Plan and FY 2007
Budget Request — ACTION
REPLY REQUESTED BY APRIL 18, 2005
It is now time for the Centers for Medicare & Medicaid Services (CMS) to begin developing an FY 2006 Operating Plan based on the President’s Budget submission, and to begin formulating FY 2007 requirements for submission to the Department. This call letter continues our efforts to consolidate the budget formulation and operating plan development processes.
As you know, the funding level in the FY 2006 President’s Budget was tightly constrained, based in part on the Administration’s commitment to deficit reduction. I expect that the funding level in the FY 2007 budget will be similarly limited. As a result, I strongly encourage each component to pay strict attention to the funding level guidance contained in this call letter and to prioritize your requests accordingly.
In a break with last year’s process, CMS information technology (IT) budgeting activities are not included as part of this call letter. OIS has issued a separate call letter for agency-level IT requirements. The IT funding needs that you are currently working on will eventually be woven into an integrated budget after review by the Information Technology and Investment Review Board (ITIRB).
Beginning in FY 2006, ongoing Medicare Modernization Act (MMA) requirements will be included as part of our traditional Program Management request. OFM will continue to track individual MMA activities by project number and will then assemble activities by Program Management line item (fund source). This process will allow OFM to report and effectively justify agency-level MMA funding requirements.
Consistent with the President's Management Agenda initiative to better integrate budget and performance, I am asking you to crosswalk each of your requested projects to at least one of the Department's 10 x 10 objectives and, where possible, to at least one CMS GPRA goal. I ask that you indicate in your glossary sheets the primary 10 x 10 and GPRA goals supporting each project. If an individual project is supported by more than one primary 10 x 10 objective or GPRA goal, indicate all applicable objectives and goals in your glossary sheets, as needed.
The information I request will be used to develop the annual FY 2006 Operating Plan and the FY 2007 DHHS request, along with other supporting materials for the Chief Operating Officer, the Strategic Planning and Management Council, and the Administrator. A profile of current FY 2005 requirements and the FY 2006 President’s Budget is available for your consideration as you prepare the FY 2006/FY 2007 request. OFM will use this information to justify and defend FY 2007 budgetary requirements. Most projects (existing or new) will require a separate justification that will be used when presenting your needs to the Chief Operating Officer, the Strategic Planning and Management Council, and the Administrator.
I trust you will find this process very helpful. Thank you for your support and for the timely submission of your requests.
TABLE OF CONTENTS
GENERAL INSTRUCTIONS:
What’s New 4
Action Steps 4
Timeline 4
Responses 5
Review Process 5
FY 2006/FY 2007 Baseline 5
MMA Funding 6
New Initiatives for FY 2006 6
Budget Request Spreadsheets 6
Glossaries 7
Location of Files 8
Government Performance and Results Act 9
Points of Contact 10
SPECIFIC BUDGET ACCOUNT INSTRUCTIONS:
Medicare Operations 11
Medicare Modernization Act 13
Medicare Integrity Program 13
MIP/Wedge Funds 13
Research 14
Information Technology 14
Survey & Certification 14
Quality Improvement Organizations Support Contracts 14
Federal Administration Accounts 15
Printing and Postage 15
Travel 16
Administrative Contracts and Intra-Agency Agreements 16
Inter-Agency Agreements (Non-DHHS) 17
Training 17
Other Accounts 17
Administrative Services/Rent/Mortgage 18
GENERAL INSTRUCTIONS
The attachments to this memo consist of Excel spreadsheets and Microsoft Word narratives. It is important that you do not change the format or column widths of the spreadsheets. The attachments are identified in detail at the end of this memo.
What’s New
While the FY 2006/FY 2007 call letter process is very similar to last year’s process, there are several changes that OFM would like to highlight. First, your MMA requirements should be included as part of your overall Program Management request. There is no separate appropriation for MMA requirements beginning in FY 2006. Second, the Agency’s IT budget is being developed under a separate process and will be incorporated into an integrated budget after ITIRB consideration. Third, all component funding requests for FY 2006 and FY 2007 are to be shown on legal-size spreadsheets, by fund source. Fourth, OFM is not requesting an additional glossary for your FY 2007 FTE requirements. We anticipate straight-lining our FY 2007 FTE request at the same level as the FY 2006 President’s Budget. Fifth, OFM is not requesting that you tie your requests to the same number of goals and priorities as last year. Instead, we ask that you crosswalk each project to the Department’s 10 x 10 objectives and to CMS’ GPRA goals.
Action Steps
• Download the information found on the “N” drive for your component, by fund source.
• Review the amounts provided for FY 2006. You are permitted to shift funds between projects as long as you stay within the totals for MMA and non-MMA for your component. If new projects are needed, include those as part of the FY 2006 “Other” column.
• Provide the amounts required for FY 2007 (planning level equals FY 2006 President’s Budget minus 2.3 percent). Utilize Tier I (equals FY 2006 President’s Budget), Tier II (1.7-percent increase over the FY 2006 President’s Budget) and the “Other” column, as needed. Offsets and reductions made to accommodate new projects should be highlighted in both your budget request and glossary sheets.
• Fill out the necessary glossary sheets.
• The materials are to be reviewed and approved by your Office/Center Director. Save the information on the “N” drive and send an email to KHeffler and GShadder when this has been completed.
• Deliver one printed copy of your component’s budget submission to OFM/Budget & Analysis Group (ATTN: Jeff Pleines/Kevin Heffler) and one to OFM/Financial Services Group (ATTN: Glenda Shadder). This step serves as your formal component submission.
Timeline
Attached is a consolidated timeline of FY 2005 budget execution activities, activities necessary to submit the FY 2007 budget request to the Department by early June, and to have an FY 2006 Operating Plan in place by October 1, 2005 (Timeline.xls). Please review the consolidated timeline. We will rely on your strict adherence to these deadlines to effectively vet your materials prior to developing formal budget documents.
Responses
After you have approved the budget documents for your component, file the documents in your component-specific folder on the “N” drive and then send an email to KHeffler and GShadder informing them that your requests are complete. Following this, please deliver one printed copy of your component’s budget submission to OFM/Budget & Analysis Group (ATTN: Jeff Pleines/Kevin Heffler) and one printed copy to OFM/Financial Services Group (ATTN: Glenda Shadder). Receipt of your component’s written request will serve as your formal submission. Any changes required after your formal submission must be approved by you — the component director — and will be considered by OFM on a case-by-case basis. Your response is due no later than Monday, April 18, 2005.
Review Process
OFM will be responsible for making funding recommendations to the Chief Operating Officer, the Strategic Planning and Management Council, and the Administrator with respect to the FY 2006 Operating Plan. OFM will use small groups to work with components to allocate funding based on spending targets established within the FY 2006 President’s Budget. OFM will also work with CMS leadership to establish an FY 2007 budget and to create a strategy for presenting and defending these requirements.
FY 2006/FY 2007 Baseline
The FY 2006 Operating Plan and the FY 2007 budget formulation exercises are based on the funding levels included in the FY 2006 President’s Budget (detailed in the FY 2006 Justification of Estimates for Appropriations Committees, commonly referred to as the Congressional Justification/Green Book). The FY 2006 President’s Budget funding level is the baseline (base section) for developing CMS’ FY 2006 Operating Plan. Your FY 2006 President’s Budget amounts by project are provided for you on the component-specific spreadsheets. You may revise the amounts of your FY 2006 President’s Budget line items (individual projects) in the operating plan as long as you do not exceed your component’s MMA and non-MMA totals. The operating plan will be a composite of the FY 2005 projects that will continue in FY 2006 and any new projects that are mandated or required for FY 2006. Requests for projects that exceed the FY 2006 President’s Budget should be shown in the “Other” column.
As in past years, we will utilize a tiered approach for FY 2007 budget formulation activities. Each spreadsheet includes tiers for FY 2007 requests at the Planning Level (2.3 percent less than the FY 2006 President’s Budget), at Tier I (equal to the FY 2006 President’s Budget), and at Tier II (1.7 percent above the FY 2006 President’s Budget). In addition, we have provided an “Other” column for FY 2007 funding requirements exceeding Tier II guidance, in total. There is no funding limitation for projects listed in the “Other” column. A combination of columns may be used to reflect the total funding requested for individual projects, as long as you do not exceed the funding level guidance for the Planning Level, Tier I and Tier II columns, in total, for your component. Components are to place projects in each of the columns based on the priority ranking indicated in your glossaries (i.e., the Planning Level should reflect your component’s highest priority projects, followed by increasingly lower priority projects in Tiers I, II, and the “Other” column). In general, projects included in the “Other” column will be considered your lowest priority items. OFM will carefully consider the priority assigned to each project requested in the “Other” column when determining the Agency’s FY 2007 budget. Requests for new projects in FY 2007 may be included within any tier, depending on priority; however, please indicate all funding offsets for new projects included in the Planning Level, Tier I or Tier II columns. These offsets should be clearly displayed in your component budget request spreadsheets and justified in your glossary sheets.
MMA Funding
There is no separate fund source for ongoing MMA activities beginning in FY 2006. Components should reflect requests for continuing (FY 2006) funds for current (FY 2005) MMA projects as part of your base request within the Program Management account. In FY 2006, any requests for new MMA-related projects not included in the FY 2004/2005 MMA operating plan should be included in the FY 2006 “Other” section of your component’s budget request spreadsheets. Requests for FY 2007 MMA funding should follow the funding level and priority guidance contained in the preceding paragraph.
New Initiatives for FY 2006
It is imperative that you review the Congressional Justification/Green Book for initiatives funded for the first time in the FY 2006 President’s Budget. Please include these items in your request, as necessary. You may substitute, delete, or add projects to your base request as long as you do not exceed your component-total FY 2006 President’s Budget amount.
Budget Request Spreadsheets
You must complete a budget request spreadsheet (BudgetRequest.xls) for all requested projects for the following funding sources:
• Medicare Operations (Med Ops)
• Medicare Integrity Program (MIP)
• Research
• Federal Administration (Federal Admin)
The budget request spreadsheet is formatted as a legal-size document, so that funding for a specific project, for all FY 2006 and FY 2007 categories, can be easily located in the same row. Detailed information for preparing this spreadsheet is included in BudgetRequest.xls. In addition to a blank format/spreadsheet with instructions, we have prepared component-specific spreadsheets for activities funded in FY 2005 in the Med Ops, MIP, Research, and Federal Admin (excluding IT and Training) fund sources. These spreadsheets are located in your component-specific folder on the “N” drive.
Should we not receive an appropriation by October 1, 2005, CMS will be required to operate under a Continuing Resolution. In order to plan for such a possibility, please note in the appropriate spreadsheet whether funding for specific projects will be required during the first quarter of FY 2006. Funds that CMS receives during the first quarter will be devoted to these activities.
If you make a request from fund sources that you have never utilized before (i.e., no component-specific spreadsheet included in component folder), complete the request using the blank spreadsheet (BudgetRequest.xls) provided and incorporate this information in the “Other” section of the spreadsheet for FY 2006, and in the Planning Level, Tier I, Tier II, or “Other” columns for FY 2007.
Make sure to fill in the account title and other identifying information as required, and save these files in your component’s specific subdirectory on the “N” drive.
Glossaries
Certain fund sources require a glossary (Glossary-OpPlan.doc) for continuing and new projects, as reflected in the chart below. Given the voluminous number of activities, you must limit your response for each project to one page, where possible. Prepare glossaries for each project on a single page, for each fund source. Label new project requests as “new” and assign a number, i.e., “New1, New2, etc.,” that reflects priority order. When assigning priority to existing and new projects, please rank each project in “1-n” order of importance (please refer to Glossary-OpPlan.doc). Your glossaries should include relevant workload data to the extent possible.
Preparation of operating plan glossaries will require you to save the document with a new file name (since you are developing a new file). “Glossary-OpPlan.doc” is the format and the new file should be named/saved as follows:
GOP + Project No. (or New1, etc.) + (name of funding source) + (name of component).doc
Examples are:
GOP-XXXX-MO-CBC.doc GOP-New1-MIP-OFM.doc
GOP-XXXX-Research-ORDI.doc GOP-XXXX-SC-CMSO.doc
GOP-XXXX-FAPrinting-CMM.doc GOP-XXXX-FAContracts-OFM.doc
By following this format, all of your files will be listed together in your folder and sorted by project number. Refer to the table below for information on glossary requirements and file names:
|PREPARATION OF GLOSSARIES |
|ACCOUNT |YES/NO |FILE NAME |
|Medicare Operations |Yes |Glossary-OpPlan.doc |
|Medicare Integrity Program |Yes |Glossary-OpPlan.doc |
|Research |Yes |Glossary-OpPlan.doc |
|Federal Administration: |
| Printing and Postage |Yes |Glossary-OpPlan.doc |
| Travel |No |N/A |
| Contracts & Intra-Agency Agreements |Yes |Glossary-OpPlan.doc |
| Inter-Agency Agreements (Non-DHHS) |Yes |Glossary-OpPlan.doc |
| Training |No |N/A |
| Administrative Services |Yes |Glossary-OpPlan.doc |
Attachment 2 consists of a chart displaying current 10 x 10 Department-wide Management and Program Objectives, together with a listing of current GPRA goals. Please utilize the guidance contained in this attachment when preparing your glossaries.
Location of Files
All files are located in a shared directory (06-07Budget) on the “N” drive, with a subdirectory/folder for each component.
All Central Office Executive Officers, along with a limited number of additional component staff, will have access to this drive, in addition to the OFM budget formulation and execution staff. Individual components will have their access limited to their specific subdirectory/folder.
Component folders include all the documents necessary to complete the FY 2006/2007 budget formulation and execution process. Each folder includes component-specific files for Med Ops, MIP, Research, and Federal Admin (excluding IT and Training), along with a blank budget request spreadsheet (if needed). Please use these documents to develop your component requests.
Components are to save their completed requests in the component folders on the “N” drive following Center/Office Director approval, and then notify KHeffler and GShadder via email that your completed requests are in your folder. You will no longer have access to the “N” drive after your submission. In general, no change to component requests will be allowed after the formal submission to OFM. Subsequent revisions to component requests must be approved by the Center/Office Director, or Regional Administrator, and forwarded by email to KHeffler and GShadder. OFM will consider each revision on a case-by-case basis. In addition, components are to deliver one printed copy of their budget submission to OFM/Budget & Analysis Group (ATTN: Jeff Pleines/Kevin Heffler) and one printed copy to OFM/Financial Services Group (ATTN: Glenda Shadder). This step serves as your component’s formal submission to OFM.
You are reminded not to change the names of files in your subdirectories/ folders, except for the operating plan glossaries you will be creating. (See Glossary section for further information, page 7.)
Staff from OFM will prepare the consolidated CMS budget requests for Med Ops, MIP, and Federal Admin (excluding IT and Training). OIS staff, on behalf of the ITIRB, will prepare a consolidated IT request for the entire agency. The OOM/Learning Resource Group will prepare the consolidated request for Federal Admin/Training. ORDI staff will prepare the consolidated CMS Research request. CMSO staff will prepare both the consolidated CMS Survey & Certification request and the CLIA update. OCSQ will prepare the consolidated CMS request for Quality Improvement Organizations (QIO) support contracts.
The structure of the 06-07 Budget directory and folders on the “N” drive is as follows:
“N” Drive
06-07Budget
Administrator
CBC
CMM
CMSO
HPO
OACT
OAGM
OCSQ
OEA
OEOCR
OFM
OHS
OIS
OL
OOM
ORDI
OSORA
Regions
Government Performance and Results Act
Beginning with the FY 2006 budget cycle, all DHHS Operating Divisions were required to use performance information in justifying their budget requests. In accordance with the current Management Agreement, we will again submit an integrated performance budget for FY 2007, linking resource requirements to performance information.
The GPRA goals included in Attachment 2 are from the FY 2006 President’s Budget. Your requests should be linked to one or more of CMS’ existing GPRA goals, where possible, and to one or more of the 10 x 10 Department-wide Management and Program Objectives. Please indicate this linkage in the glossary sheets, in the space provided.
Individual GPRA goal updates will be submitted under separate cover. Please review this list and inform your OFM GPRA contact of the need to add or delete goals appropriate for FY 2007. Significant new activities may be considered for inclusion in the agency GPRA plan. OFM staff will contact your component to update GPRA goals as appropriate for FY 2007. For further information, please contact Harriet Rubinson at (410) 786-0366.
|POINTS OF CONTACT |
|FUNDING ACCOUNT |BUDGET FORMULATION |BUDGET EXECUTION |
|Medicare Operations |Cindy D’Annunzio/61878 |Jackie Burkindine/65737 |
| |Mailstop N3-05-06 |Mailstop C3-13-06 |
| |Location N3-08-05 |Location C3-10-06 |
|MMA |Linda Dauses/65671 |Julie Apel/64476 (Med Ops/MMA) |
| |Mailstop N3-05-06 |Mailstop C3-13-06 |
| |Location N3-07-28 |Location C3-11-15 |
| | | |
| | |Terri Krause/61376 (Alternate) |
| | |Mailstop C3-13-06 |
| | |Location C3-11-25 |
|Medicare Integrity Program |Tom Giancola/67043 |Ken Frank/65659 |
| |Mailstop N3-05-06 |Mailstop C3-13-06 |
| |Location N3-08-15 |Location C3-11-17 |
|Research |Kemuel Johnson/68200 |Mary Carol Weaver/66635 |
| |Mailstop N3-05-06 |Mailstop C3-20-11 |
| |Location N3-07-25 |Location C3-26-26 |
|Federal Administration |James Grant/66456 |Glenda Shadder/69046 |
| |Mailstop N3-05-06 |(Federal Admin – Overall) |
| |Location N3-07-24 |Mailstop C3-14-16 |
| | |Location C3-09-15 |
| | |Contracts & IAs: Trish Moore/67678 |
| | |Printing: Rita Reinsel/67444 |
| | |Training: Rita Reinsel/67444 |
| | |Travel: Sandy Wychryst/65439 |
|Information Technology |Ron Topper/65406 |Julia Fultz, 68109 |
| |Mailstop N3-05-06 |Mailstop N3-13-27 |
| |Location N3-08-25 |Location N3-14-01 |
| | | |
| |Janet Tierney/62985 |Mary Keogh/66563 |
| |(IT Investment Management Process) |(IT Execution) |
|FTEs and Payroll |Jeff Pleines/60684 |N/A |
| |Mailstop N3-05-06 | |
| |Location N3-08-04 | |
|Performance Measurement and GPRA |Harriet Rubinson/60366 |N/A |
| |Mailstop N3-05-06 | |
| |Location N3-04-04 | |
|“N” Drive Access |Kevin Heffler/65892 |N/A |
| |Mailstop N3-05-06 | |
| |Location N3-08-03 | |
| | | |
|Delivery of Printed Requests |Kevin Heffler/65892 |Glenda Shadder/69046 |
SPECIFIC BUDGET ACCOUNT INSTRUCTIONS:
MEDICARE OPERATIONS:
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FY 2006
FY 2006 funding for Medicare Contractor ongoing functions is not part of this exercise. The components have already been given funding targets for FY 2006 through the Budget and Performance Requirements (BPRs) call letter. You should still prepare glossary sheets for ongoing projects. Information needed for FY 2007 Medicare Contractor ongoing functions is identified in the budget formulation section below and should be included on your glossary sheets.
The spreadsheets provided to each center/office contain the approved FY 2005 projects for all non-IT activities. OIS will be responsible for providing IT information for the entire agency.
The FY 2006 President’s Budget includes many earmarks. These have been highlighted at the beginning of each component’s spreadsheet. Components are not to change the total amounts for these earmarks. The “FY 2006 Component Request” column has already been pre-filled with the President’s Budget amounts.
The FY 2006 and FY 2007 “Base” component requests cannot exceed the FY 2006 President’s Budget amount for each individual center/office. In most cases (on a component basis) the total amount available in the FY 2006 President’s Budget is less than the currently approved total amount in the FY 2005 Operating Plan. It may be necessary to adjust the amounts requested for your projects to fit the President’s Budget level or move some of your projects into the “Other” section for FY 2006 and the Tier I, Tier II, and/or “Other” section for FY 2007.
FY 2007
For FY 2007 budget formulation purposes, the most effective justification must provide cost and workload estimates, along with explanations of significant increases or decreases from the FY 2006 President’s Budget, where applicable, in “Glossary-OpPlan.doc.” Components should pay particular attention to the data requests below, although providing workload data for any project will strengthen your justification:
CMM: Provider Inquiries--Workloads and cost estimates for FY 2005 through FY 2007.
CBC:
• Fee-For-Service Appeals--Workloads and cost estimates for FY 2005 through FY 2007;
• Beneficiary Inquiries--Workloads and cost estimates for FY 2005 through FY 2007.
MEDICARE MODERNIZATION ACT (MMA):
The MMA budget was a separate 2-year appropriation for FY 2004/2005. Beginning in FY 2006, MMA funding will be included in the traditional Program Management request. Many of the projects started in FY 2004/2005 will be ongoing. In FY 2006 they will be included in their respective Program Management lines as follows: Medicare Operations, Research, and Federal Administration. Components are asked to separately identify all National Medicare Education Program related MMA activities in the Medicare Operations request.
Any activities moving forward should be added to the correct funding source as listed above. Please continue to use the same project number (old FMIB) that was used under the previous FY 2004/2005 MMA appropriation for tracking purposes.
Questions on MMA should be directed to the points of contact listed on page 11.
MEDICARE INTEGRITY PROGRAM:
Total Medicare Integrity Program (MIP) funding for FY 2006 is targeted at $800.0 million. Included in this target is $720.0 million for ongoing activities. Centers/offices should be prepared to plan for FY 2006 and 2007 at the $720.0 million funding level. Since we do not anticipate any across-the-board increase, an adjustment to any line item would require an offsetting level of effort in another.
Of the remaining $80.0 million in FY 2006, $75.0 million is available to conduct oversight activities for safeguarding the Medicare Part D Prescription Drug Benefit and Medicare Advantage Programs, and $5.0 million is available for Medicaid and SCHIP Financial Management activities.
The spreadsheet filed in each center/office folder contains the approved FY 2005 projects for all non-IT activities. OIS will be responsible for providing IT information for the entire agency using data submitted in response to their call letter dated February 14, 2005.
MIP/WEDGE FUNDS:
Detailed “wedge fund” instructions will be provided from the Department in the near future. As a result, detailed component guidance is not included in this call memorandum, but will be transmitted separately.
RESEARCH:
The President’s FY 2006 Research, Demonstration, and Evaluation (RD&E) budget is $45.194 million. Of this total, $13.6 million is targeted for the Medicare Current Beneficiary Survey, $19.7 million for MMA activities and the remaining $11.9 million is available for discretionary projects. The FY 2007 base component request should be equal to FY 2006 minus 2.3 percent.
The spreadsheets provided for each center/office (OCSQ, CMM, CMSO, and ORDI) contain the FY 2005 approved funding levels and the FY 2006 proposed funding levels by project that were included in the President’s Budget.
All component requests in FY 2006 that exceed the FY 2006 President’s Budget total should be included in the “Other” section of the spreadsheet. This includes requests from components that do not have any items in the RD&E budget for FY 2005 and FY 2006. Be sure to identify those projects that support legislative initiatives in “Glossary-OpPlan.doc.”
INFORMATION TECHNOLOGY:
Instructions for preparing the investment technology portion of the FY 2006 Operating Plan and FY 2007 budget formulation are included in the email from OIS, dated 02/15/05, to Office/Center Directors and Regional Administrators. Questions regarding the IT investment management process should be directed to Janet Tierney, Director, OIS/Planning Management & Support Group/Division of Investment Tracking & Assessment, 62985.
SURVEY & CERTIFICATION:
The CMSO/Survey & Certification Group has distributed a separate call memo. Please contact David Escobedo/65401 or Jim Hackenberg/69325 for additional information.
QUALITY IMPROVEMENT ORGANIZATIONS (QIO) SUPPORT CONTRACTS:
OCSQ is responsible for developing a consolidated QIO support contract request. Please contact Udo Nwachukwu/67234 or Lloyd Marshall/69881 for additional information.
FEDERAL ADMINISTRATION ACCOUNTS:
For planning purposes, listed below is a partial comparison of the FY 2005 Operating Plan and the FY 2006 President’s Budget for Federal Administration:
| |FY 2005 Allocation |FY 2006 President’s |Percentage |
|Activity |(Operating Plan) |Budget |Increase/ |
| | | |Decrease |
|Information Technology |$25.5M |$25.8M |+1.2% |
|Printing/Postage |$5.5 M |$5.5 M |0% |
|Travel |$8.3 M |$10.8 M |+30.0% |
|Contracts/IAs |$33.0 M |$32.2M |-2.4% |
|IAs (Non-DHHS) |$3.3M |$3.3M |0% |
|Training |$2.7M |$2.7M |0% |
Included in your component folder are spreadsheets for the above line items (excluding IT and Training) that include FY 2005 Operating Plan and FY 2006 President’s Budget amounts. You may revise the amounts for your FY 2006 President’s Budget line items as long as you follow the increased/decreased or no-change percentages listed above for your component total. Additional FY 2006 requirements must be submitted in the “Other” section of the spreadsheet.
OIS will be responsible for providing IT information for the entire agency using data that components submitted in response to the IT call letter issued on February 15, 2005.
Printing and Postage
The FY 2006 President’s Budget includes $3.0 million for Printing and $2.5 million for Postage – the same as in FY 2005.
All administrative printing and postage requirements must be included on the component-specific Printing/Postage spreadsheets. The attached file “BudgetRequest.xls” provides specific instructions on completing the spreadsheet. Printing and postage costs associated with Administrative Contracts are not to be included in the cost of the contract, but reflected on the Printing/Postage spreadsheet. Microsoft Word file “Glossary-OpPlan.doc” is required for description and justification for all requested activities/projects.
If you or your staff has any questions on preparing the Federal Admin/Printing and Postage request, please contact Rita Reinsel at (410) 786-7444. Members of the OOM/Administrative Services Group/Division of Publications Management Services can assist in preparing printing and postage estimates.
Travel
The FY 2006 President’s Budget includes $10.8 million for Travel – an increase of $2.5 million.
Current travel purpose codes are included (TravelPurposeCodes.doc) for use in preparing FY 2006/2007 Travel budget requests. All travel must be identified separately and included on the component-specific Travel spreadsheets. The attached file “BudgetRequest.xls” provides specific instructions on completing the spreadsheet. No travel costs should be included in any other project line item. If administrative travel is included in an IT investment request, the travel needs must be resubmitted with your response to this call letter. Do not include courier fees for ticket delivery in your travel estimates. These fees will be paid from a central office common expense account.
OFM will provide a central fund to cover agency-directed details and relocations, Commissioned Corps Officer retirement expenses, and travel expenses for the agency’s Combined Federal Campaign Loaned Executive Officer.
Glossaries are not required to support Travel requests.
If you or your staff has any questions on preparing the Federal Admin/Travel request, please contact Sandy Wychryst at (410) 786-5439. Members of the OFM/Accounting Management Group/Division of Accounting Operations can assist in preparing travel estimates.
Administrative Contracts and Intra-Agency Agreements
The FY 2006 President’s Budget includes $32.2 million for Administrative Contracts and Intra-Agency Agreements — a decrease of $0.8 million.
All Administrative Contract requirements must be included on the component-specific spreadsheets. Intra-Agency Agreements (internal to DHHS) should be included on this spreadsheet. The attached file “BudgetRequest.xls” provides specific instructions on completing the spreadsheet. Microsoft Word file “Glossary-OpPlan.doc” is required for description and justification for all requested projects.
IT investments that require contracts will be identified through the information that is provided by OIS.
If you or your staff has any questions on preparing the Federal Admin/Administrative Contracts request, please contact the Office of Acquisitions and Grants Management or Trish Moore at (410) 786-7678.
Inter-Agency Agreements (Non-DHHS)
The FY 2006 President’s Budget includes $3.3 million for Inter-Agency Agreements (IAs) — the same as in FY 2005.
All IAs requirements must be included on the component-specific spreadsheets. The attached file “BudgetRequest.xls” provides specific instructions on completion of the spreadsheet. Microsoft Word file “Glossary-OpPlan.doc” is required for description and justification for all requested projects.
If you or your staff has any questions on preparing the Federal Admin/Non-DHHS Inter-Agency Agreements, please contact Trish Moore at (410) 786-7678.
Training
The FY 2006 President’s Budget includes $2.7 million for Training — the same as in FY 2005.
The OOM/Learning Resources Group has provided information (Training.doc) on the CMS FY 2006/2007 learning plans, which explains how to complete the training worksheet (Training.xls). This attachment is similar to that used in the FY 2005/2006 budget process. However, there have been a number of changes; please read the instructions carefully before completing your component request.
All training must be identified separately and included on the training spreadsheet for FY 2006 (Training.xls). No training costs should be included in any other project line item. If training costs were included in an IT investment request, the training needs must be resubmitted with your response to this call letter. Also included in the training materials are a list of FY 2006/2007 learning categories, FY 2005 project numbers and Administrator priorities (Training.doc).
If you or your staff has any questions on preparing the Federal Admin/Training request, please contact Anna Barton-Thomas at (410) 786-4302 or Harry Kessler at (410) 786-3009.
Other Accounts
Funding requirements for the remaining administrative line items, i.e., overtime, awards, and per capita supplies, will be recommended by the Chief Financial Officer, the Chief Operating Officer, the Strategic Planning and Management Council, and then approved by the Administrator.
Administrative Services/Rent/Mortgage
The FY 2006 President’s Budget includes $11.8 million for Administrative Services and a total of $36.2 million for rent and the single-site building loan.
All Administrative Services requirements, including the rent and the mortgage, are included on the component-specific spreadsheets for OOM, OEA, OEOCR, and the ROs. Include requests in FY 2006 and FY 2007 for the rent/mortgage and Other Procurement items, such as the purchase and maintenance of furniture and equipment, job orders, transportation costs, reasonable accommodations, etc., on these sheets. Only OOM needs to complete the line items regarding rent and mortgage. The rent should be reduced by the Congressional limitation amount before submission to OFM. (The cost of the IA for the Operations and Maintenance expenses of the HHH building should be included with the Contracts and not included with the rent/expenses.) OEOCR should include their figures for ADA expenses in the Administrative Services line-item and the request for Personal Assistants Fees in the Contracts spreadsheet. OEA and the ROs are only responsible for their respective Administrative Services line-item requests.
The attached file “BudgetRequest.xls” provides specific instructions on completion of the spreadsheet. Microsoft Word file “Glossary-OpPlan.doc” is required for description and justification for all requested projects.
If you or your staff has any questions on preparing the Federal Admin/Administrative Services request, please contact Rita Reinsel at (410) 786-7444.
7 Attachments
1. 05-06-07Timeline.xls
2. Department 10 x 10 Crosswalk with GPRA/PART/Key Strategic Initiatives/PMA and GPRA Goal List
3. BudgetRequest.xls (blank request with instructions)
(Component-Specific Spreadsheets [Med Ops, MIP, Research, Federal Admin] included in component folders)
4. Glossary-OpPlan.doc (blank justification with instructions)
5. TravelPurposeCodes.doc
6. Training.doc (Learning Plan, Learning Categories, & Administrator Priorities)
7. Training.xls (Training Request & FY 2005 Project Numbers)
cc:
Central Office Executive Officers
Consortia Liaison & Operations Analyst
|FY 2005/2006/2007 BUDGET EXECUTION/FORMULATION TIMELINE | | | | |
| |FY |ACTIVITY |DATE |FSG |BAG |Other |
| | | | | | | |
|1 |2006 |OIS issues IT call letter. |February 15 | | |⎫ |
| |2007 | | | | | |
| | | | | | | |
|2 |2006 |Begin development of the FY 2006/FY 2007 budget call letter. Clearance process |February 23 |⎫ |⎫ | |
| |2007 |begins March 7. | | | | |
| | | | | | | |
|3 |2005 |Prepare Status of Funds Report for period 10/01/04 through 02/28/05 and distribute| March 15 |⎫ | | |
| | |to all components and COO/Strategic Planning Council. | | | | |
| | | | | | | |
|4 |2006 |Clear OFM review, brief components and distribute call letter for FY 2007 budget |March 16 - March |⎫ |⎫ | |
| |2007 |formulation and FY 2006 budget execution (Medicare Operations, Medicare Integrity |18 | | | |
| | |Program, Survey & Cert, Research, Federal Administration, Revitalization Plan, and| | | | |
| | |QIO support contracts). | | | | |
| | | | | | | |
|5 |2006 |Present call letter to Central Office Executive Officers. | March 17 |⎫ |⎫ | |
| |2007 | | | | | |
| | | | | | | |
|6 |2006 |IT guidance and initial recommendations. |Late March | | |⎫ |
| |2007 | | | | | |
| | | | | | | |
|7 |2007 |GPRA goal update requests sent to components. |4-Apr | |⎫ | |
| | | | | | | |
|8 |2006 |Receive responses to call letter from CMS components. | April 18 |⎫ |⎫ | |
| |2007 | | | | | |
| | | | | | | |
|9 |2006 |ITIRB presents prioritized IT list and budget recommendations to COO. |April 21 | | |⎫ |
| |2007 | | | | | |
| | | | | | | |
|10 |2007 |Receive GPRA update responses from components. |25-Apr | |⎫ | |
| | | | | | | |
|11 |2006 |IT funding recommendations due to BAG/FSG. |Early May | | |⎫ |
| |2007 | | | | | |
| | | | | | | |
|12 |2006 |Consolidate component responses into one agency response. Includes response to |May 2 - 13 |⎫ |⎫ | |
| |2007 |separate budget calls (IT, Training, Survey & Certification, Research). | | | | |
| | | | | | | |
|13 |2007 |Utilize consolidated CMS FY 2007 budget requests and prepare FY 2007 budget |May 16 - Early June |⎫ | |
| | |submission for the Department. | | | |
| | | | | | | |
|14 |2007 |FY 2007 budget review meeting with CFO (DHHS Submission). |Late May | |⎫ | |
| | | | | | | |
|15 |2007 |FY 2007 budget review meeting with COO (DHHS Submission). |Late May | |⎫ | |
| | | | | | | |
|16 |2007 |Submit CMS' FY 2007 performance budget to DHHS/ASBTF. |Early June | |⎫ | |
| | | | | | | |
|17 |2007 |FY 2007 budget briefings with DHHS Staff (BAG/CMS Staff). |Mid-June | |⎫ | |
| | | | | | | |
|18 |2005 |Prepare and distribute memo on FY 2005 admin. budget cutoff dates. |June 17 |⎫ | | |
| | | | | | | |
|19 |2005 |Forward acquisition requests that exceed $100,000 to OAGM by cutoff date. (CMS) |July 1 | | |⎫ |
| | | | | | | |
|20 |2005 |"Sweep" funds from overdue acquisitions that exceed $100,000. |July 8 |⎫ | | |
| | | | | | | |
|21 |2007 |Secretary's Budget Council Meetings. |Mid-July | |⎫ | |
| | | | | | | |
|22 |2005 |Forward acquisition requests less than $100,000 to OAGM by cutoff date. (CMS) |July 15 | | |⎫ |
| | | | | | | |
|23 |2005 |"Sweep" funds from overdue acquisitions less than $100,000. |July 22 |⎫ | | |
| | | | | | | |
|24 |2005 |Prepare Status of Funds Report for period 10/01/04 through 06/30/05 and distribute|July 18 |⎫ | | |
| | |to all components and COO/Strategic Planning Council. | | | | |
| | | | | | | |
|25 |2006 |Develop draft FY 2006 Operating Plan recommendations. |July - Sep. |⎫ | | |
| | | | | | | |
|26 |2007 |Receive and respond to DHHS Passback. |TBD | |⎫ | |
| | | | | | | |
|27 |2005 |Forward administrative obligating documents (travel orders, training nominations, |August 5 |⎫ | | |
| | |credit card purchases) to OFM by cutoff date. (CMS) | | | | |
| | | | | | | |
|28 |2005 |Reconcile budget data in the Budget Under Control System (BUCS) to the Financial |August 10 | | |⎫ |
| | |Accounting and Control System (FACS) and enter estimates (pre-obligate) of future | | | | |
| | |expenditures into BUCS. (CMS) | | | | |
| | | | | | | |
|29 |2005 |Conduct initial "sweep" of all unobligated administrative funds. |August 12 |⎫ | | |
| | | | | | | |
|30 |2005 |Forward draft FY 2005 Intra/Interagency Agreement actions to OAGM by cutoff date. |August 12 |⎫ | | |
| | |(CMS) | | | | |
| | | | | | | |
|31 |2005 |Conduct final "sweep" of all unobligated administrative funds. |September 7 |⎫ | | |
| | | | | | | |
|32 |2005 |Award all procurement actions. (OAGM) |September 14 | |⎫ |
| | | | | | | |
|33 |2006 |Finalize draft FY 2006 Operating Plan. |Early Sep. |⎫ | | |
| | | | | | | |
|34 |2007 |Submit CMS' FY 2007 performance budget to OMB. |Early Sep. | |⎫ | |
| | | | | | | |
|35 |2006 |Present draft FY 2006 Operating Plan to Chief Operating Officer and Strategic |Mid-Sep. |⎫ | | |
| | |Planning Council. (CFO) | | | | |
| | | | | | | |
|36 |2006 |Present draft FY 2006 Operating Plan to Administrator and Deputy Administrator for|Late Sep. |⎫ | | |
| | |approval. (COO & CFO) | | | | |
| | | | | | | |
|37 |2005 |End of FY 2005. |Sep. 30, 2005 | | |
| | | | | | | |
|38 |2005 |Prepare FY 2005 year-end Status of Funds Report and distribute to all components |Mid-October |⎫ | | |
| | |and COO/Strategic Planning Council. | | | | |
| | | | | | | |
|39 |2006 |Receive FY 2006 appropriation and develop apportionment schedules. |TBD |⎫ |⎫ | |
| | | | | | | |
|40 |2006 |Provide FY 2006 Operating Plan to Center/Office Directors and Regional |TBD |⎫ | | |
| | |Administrators, together with allotments and allowances and the "Rules of the | | | | |
| | |Road" memo following receipt of apportionment from DHHS/OMB. | | | | |
| | | | | | | |
|41 |2005 |Reconcile year-end budget accounts (actuals). Begin development of OMB MAX |Nov/Dec 2005 |⎫ |⎫ | |
| |2007 |database. | | | | |
| | | | | | | |
|42 |2007 |Receive and respond to OMB Passback. |Nov/Dec 2005 |⎫ | |
| | | | | | | |
|43 |2005 |OMB MAX lock-out. |January 2006 |⎫ | |
| |2007 | | | | |
| | | | | | | |
|44 |2007 |Submit CMS' FY 2007 performance budget request to Congress. |February 2006 |⎫ | |
|10 Department-Wide Management Objectives |Agency Goals |
|M1. Implement Results-Oriented Management |Strategic Initiatives |
| |Effectively manage the timely award and oversight of Medicare health plan, prescription drug, and FAR contracts (CBC) |
| |Develop processes for aligning awards with performance. (OOM) |
|2004 Rating: “E”xceptional |Improve the Agency’s performance through the consistent administration of the Master Labor Agreement. (OOM) |
| |Strengthen the project management program through the development and roll-out of standard methodologies and tools for projects CMS-wide. (OOM) |
| |Workgroup initiative: Achieve a 10 percent increase in program performance over the next three years. (CMM lead.) |
| | |
| | |
| | |
|*Retiring as a GPRA goal after FY 2005. | |
| |GPRA Goals: Implement Contracting Reform (CMM), Implement Medicare Prescription Drug Benefit (CBC), *Implement the new Medicare Endorsed Prescription Drug Card (CBC), |
| |Decrease the prevalence of Restraints in Nursing Homes (CMSO/OCSQ), Decrease the prevalence of Pressure Ulcers in Nursing Homes (CMSO/OCSQ), Decrease the Medicare |
| |Provider Compliance Error Rates (OFM). |
| |PART Milestones: - See all Medicare PART milestones |
| |PMA: Budget Performance Integration |
|M2. Implement Strategic Human Capital Management |Strategic Initiatives |
| |Maintain CMS’ Affirmative Employment Program and implement new requirements. (OEOCR) |
| |Conduct EEO and Civil Rights training. (OEOCR) |
| |Meet regulatory requirements for EEO complaint processing. (OEOCR) |
| |Develop processes for aligning awards with performance. (OOM) |
| |GPRA Goal: Strengthen and maintain diversity at all levels of CMS (OEOCR) |
| |PART Milestones: N/A |
| |PMA: Human Capital |
|M3. Improve Grants Management Operation And |Strategic Initiatives |
|Oversight |Notices of Grant Award will be issued to 54 SHIPs (all 100) by March 31, 2005 to enable SHIPs to conduct outreach, counseling services, training and data reporting. |
| |(CBC) |
| |GPRA Goals: Accountability through reporting in the Medicaid Infrastructure Grant Program (CMSO) |
| |PART Milestones: N/A |
| |PMA: Financial Management and Budget Performance Integration |
|M4. Complete The FY 2005 Competitive Sourcing |No Strategic Initiatives |
|Program | |
| | |
| | |
|2004 Rating “E”xceptional | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: Competitive Sourcing |
|M5. Improve Information Technology Management |Strategic Initiatives |
| |Use technology effectively to support efficient Center operations. (CBC) |
| |Establish and manage infrastructure to facilitate provider and beneficiary inquiries. (OIS) |
| |Establish business intelligence infrastructure to facilitate enhanced information management initiatives through CMS Internet. (OIS) |
| |Standardize Front Ends for Claims Processing. (OIS) |
| |Implement Enterprise Data Center Strategy. (OIS) |
| |Develop the IT Governance and IT Workforce Planning processes. (OIS) |
|2004 Rating “E”xceptional |Workgroup Initiative: Continuity of Operations and Disaster Recovery Plan implemented and tested for 100 percent of systems that are “major” (IT systems that must be |
| |operational for CMS to successfully perform its business functions and cost more than $10 million). (OIS lead) |
| |GPRA Goals: Develop and Implement an IT (Enterprise) Architecture (OIS) |
| |Improve CMS Information Systems Security (OIS) |
| |PART Milestones: N/A |
| |PMA: e-Gov and Financial Management |
|M6. Consolidate Management Functions and Achieve |Strategic Initiatives |
|Administrative Efficiencies |Implement the National Provider Identifier Program. (OFM) |
| |Process all Secretarial and Administrator controlled correspondence in accord with the established timeframes: six work days for Secretarial Correspondence and 10 work|
| |days for Administrator Correspondence. (OSORA) |
| |Publish CMS regulatory initiatives on the Fourth Friday of the Month in accord with the workload/schedules identified in the Quarterly Provider Update. (OSORA) |
| |Workgroup Initiative: Increase by a minimum of three, the number of service and function consolidations and/or shared services. (OOM lead) |
| |GPRA Goals: Increase the use of electronic commerce/standards in Medicare (OIS) |
| |PART Milestones: N/A |
| |PMA: Financial Management |
|M7. Improve Financial Management |Strategic Initiatives |
| |Improve Federal Medicaid/SCHIP Financial Management. (CMSO) |
| |Improve documentation of projection models in preparation for the FY 2006 audit of the CMS Financial Statement. (OACT) |
| |Build-in recommendations of the Medicare Technical Review Panel into projection models for use in the FY 2006 President’s Budget and the 2005 Trustees Report. (OACT) |
| |Projections of national health expenditures. (OACT) |
| |Calculation of payment updates for most Medicare providers. (OACT) |
| |Improve validity of provider profit margin calculation. (OACT) |
| |Improve CMS Financial Management and CFO Audit Processes. (OFM) |
| |Implement the Health Integrated General Ledger Accounting System (HIGLAS). (OFM) |
| |Enhance CMS’ Program Integrity efforts for MMA and future initiatives. (OFM) |
| |Establish a process and system to record and track beneficiary co-payments and other Part D related expenditures. (OFM) |
| |Workgroup Initiative: Reduce HHS Improper Payments by 50 percent across the board. (OFM lead) |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
|2004 Rating: “E”xceptional | |
| |GPRA Goals: Reduce the Medicare FFS Error Rate (OFM) |
| |Decrease the Medicare Provider Compliance Error Rate (OFM) |
| |Reduce the Medicare Contractor Error Rate (OFM) |
| |Assist States in Conducting Medicaid Payment Accuracy Studies (OFM) |
| |Improve Effectiveness of Administration of MSP provisions (OFM) |
| |Sustain Medicare payment timeliness consistent with statutory floor & ceiling requirements |
| |Maintain CMS’ improved rating on financial statements |
| |PART Milestones: Analyze data collected through payment accuracy measurement demonstration projects for FY 2004 to further develop PERM methodology for Medicaid and |
| |SCHIP. (OFM/CMSO) |
| |HIGLAS Go-Live with Medicare Contracting Pilot implementation at Palmetto & Empire sites (OFM) |
| |Begin Design of HIGLAS Administrative Accounting Module (OFM) |
| |Medicare Improper FFS Annual Payment Report (OFM) |
| |Expand Medicare-Medicaid data matching project (OFM) |
| |Establish financial management oversight over the rug card sponsors’ implementation (OFM) |
| |Complete QIO pilots of reducing erroneous hospital payments (OCSQ) |
| |Implement 8th SOW for QIOs, including hospital payment accuracy program (OCSQ) |
| |Pursue Performance-Based Contracting Pilot (OFM) |
| |PMA: Financial Management |
|M8. Improve Real Property Assets |Strategic Initiative |
| |Establish and execute a space plan to house CMS’ new hires. (OOM) |
| | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: N/A |
|M9. Achieve Efficiencies through HHS-wide |No Strategic Initiatives |
|Procurements | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: Financial Management |
|M10. Conduct Program Evaluations And Implement |Strategic Initiatives |
|Corrective Strategies For Any Deficiencies |Assess the NMEP communication and information channels to identify opportunities for improvement. (CBC) |
| |Workgroup Initiative: Implement a systematic approach to program evaluation for HHS programs that makes use of internal resources, reciprocal evaluations and |
| |contractors to achieve regular independent and quality evaluations to indicate that the program is effective in achieving results. (ORDI lead) |
| |GPRA Goals: N/A |
| |PART Milestones: States submit FY 2004 SCHIP Annual Reports reflecting improved reporting on poor performance measures and progress toward reducing the uninsured |
| |(CMSO?) |
| |PMA: Financial Management and Budget Performance Integration |
|10 Department-Wide Program |Key Strategic Initiatives |
|Objectives | |
|P1. Increase Access To Health |Strategic Initiatives |
|Care |Through appropriate policy and operations, ensure that CMS works effectively with health plans, prescription drug plans, and others to provide health care coverage and related services to|
| |Medicare beneficiaries. (CBC) |
| |Provide accurate, reliable, understandable, and relevant information to people with Medicare to assist them in making informed decisions about their health. (CBC) |
| |Provider Customer Service Program (PCSP). (CMM) |
| |Enhance the capacity of CMS to work with tribes. (OEA) |
| |Implement a Health Advocacy Group. (OEA) |
| |Coordinate major campaigns. (OEA) |
| |Upgrade media outreach. (OEA) |
| |Enhance partnerships. (OEA) |
| | |
| | |
| | |
|2004 Rating: “E”xceptional | |
| |GPRA Goals: Improve Satisfaction of Medicare beneficiaries with the health care services they receive (CBC |
| |Improve Medicare’s administration of beneficiary appeal process (CBC) |
| |Improve effectiveness of dissemination of Medicare information to beneficiaries (CBC) |
| |Improve beneficiary understanding of basic features of Medicare program (CBC) |
| |Improve beneficiary telephone customer service (CBC) |
| |Decrease the number of uninsured children by working with States to enroll children in SCHIP and Medicaid (CMSO) |
| |PART Milestones: Issue national coverage guidance documents (OCSQ) |
| |PMA: N/A |
|P2. Expand Consumer Choices In|Strategic Initiatives |
|Health Care And Human Services|Ensure that the rights and protections available to people with Medicare are administered effectively and timely. (CBC) |
| |Contractor Evaluation Improvement Project (CEIP). (CMM) |
| | |
| | |
|*Retiring as a GPRA goal after| |
|FY 2005. | |
| |GPRA Goals: *Implement the new Medicare endorsed Prescription Drug Card (CBC) |
| |Implement the new Medicare Prescription Drug Benefit (CBC) |
| |Implement regional PPOs (CBC) |
| |PART Milestones: Expand work of QIOs to include Medicare Advantage organizations (Part C) and prescription drug sponsors (Part D) (OCSQ) |
| |(Other PART milestones may apply here.) |
| |PMA: N/A |
|P3. Emphasize Preventive |Strategic Initiative |
|Health Measures |Develop and implement Quality Measures strategy for ambulatory care and Part D measures, hospitals, and Long Term care. (OCSQ) |
| | |
| | |
| | |
| | |
| | |
| | |
|*While activity continues, | |
|retiring as a GPRA goal after | |
|FY 2005. | |
| |GPRA Goals: *Increase the percentage of Medicaid two-year old children who are fully immunized |
| |Increase the percentage of Medicare beneficiaries who receive an annual flu and lifetime pneumococcal vaccines |
| |Increase the percentage of Medicare beneficiaries who receive a mammogram |
| |*Improve the care of diabetic beneficiaries by increasing the rate of diabetic eye exams |
| |Improve the care of diabetic beneficiaries by increasing the rate of hemoglobin A1c and cholesterol (LDL) testing |
| |Optimize the timing of antibiotic administration to reduce the frequency of surgical site infection |
| |Protect the health of Medicare beneficiaries by improving vascular access for hemodialysis |
| |PART Milestones: N/A |
| |PMA: N/A |
|P4. Prepare For And |Strategic Initiative |
|Effectively Respond to |Advance CMS’ compliance with Department of Homeland Security standards for COOP/Emergency Preparedness. (OOM) |
|Bio-Terrorism And Other Public| |
|Health Emergencies | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: N/A |
|P5. Improve Health Outcomes |Strategic Initiatives |
|(Preventing Disease And |Complete National Coverage Determinations (NCD) within MMA mandated timelines. (OCSQ) |
|Illness) |Implement BIPA Cancer Prevention and Treatment Demonstration. (ORDI) |
| |Evaluate and Submit RTCs for Chronic Care Improvement Program. (ORDI) |
| |Award contracts and implement operational infrastructure for 8th Scope of Work (SOW) for Quality Improvement Organizations (QIO). (OCSQ) |
| |Hospital Compare for Medicare beneficiaries. (OCSQ) |
| |Modify VHA’s Vista Electronic Health Record (EHR) for use in ambulatory care setting. (OCSQ) |
| |Significantly improve quality of life and survival for dialysis patients, while decreasing costs, by assuring optimal vascular access (fistulas) for hemodialysis. (OCSQ) |
| |Rollout top priority Breakthrough Projects. (OCSQ) |
| |GPRA Goals: Decrease the prevalence of physical restraints in nursing homes (CMSO/OSCQ) |
| |Decrease the prevalence of pressure ulcers in nursing homes (CMSO/OCSQ) |
| |PART Milestones: Issue National Coverage Document of preventive physical exam, cardiovascular screening blood tests, and diabetes screening test |
| |PMA: N/A |
|P6. Improve The Quality Of |Strategic Initiatives |
|Health Care (21st Century |Survey & Certification Improvement. (CMSO) |
|Health Care) |Further the Secretary’s Organ Donation Initiative by Promulgating Rules for Organ Procurement Organizations (OPO) and Transplant Hospitals by completing Proposed and Final Regulations. |
| |(OCSQ) |
| |Award Option Year 2 Contracts for ESRD Networks. (OCSQ) |
| |Develop, clear and implement a quality strategy for CMS. (OCSQ) |
| | |
| | |
|Rating: | |
|“E”xceptional | |
| |GPRA Goals: Improve the health care quality across Medicaid and SCHIP (CMSO) |
| |Assure the purchase of quality, value and performance in State Survey and Certification Activities (CMSO) |
| |Improve and sustain testing accuracy in laboratories holding a CLIA certificate of waiver (CMSO) |
| |PART Milestones: N/A |
| |PMA: N/A |
|P7. Advance Science and |Strategic Initiative |
|Medical Research (Improving |Develop “Improving Evidence for Decisions” Initiative. (OCSQ) |
|Health Science) | |
| |GPRA Goals: Assess the relationship between CMS research investments and program improvements (ORDI) |
| |PART Milestones: N/A |
| |PMA: N/A |
|P8. Improve the Well-Being and|No Strategic Initiatives |
|Safety of Families and | |
|Individuals, Especially | |
|Vulnerable Populations | |
|(“Leaving No Child Behind”) | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: N/A |
|P9. Strengthen American |No Strategic Initiatives |
|Families (Working Toward | |
|Independence) | |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: N/A |
|P10. Reduce Regulatory Burden |Strategic Initiatives |
|On Providers, Patients And |Timely Implementation of Annual Payment updates to Final Rules. (CMM) |
|Consumers’ HHS’ Services |HCPCS Coding Reform. (CMM) |
| |Competitive Acquisition Program (CAP) for Medicare Part B Drugs. (CMM) |
| |Electronic prescribing initiative. (OHS) |
| |GPRA Goals: Improve the provider enrollment process (OFM) |
| |PART Milestones: N/A |
| |PMA: N/A |
|P11. Other Related Strategic |Strategic Initiatives |
|Objectives Or Goals |Implement Medicare Data Distribution Center (Data Warehouse). (ORDI) |
| |Award New Research and Demonstration Task Order Contracts (MRAD). (ORDI) |
| |Assist the Office of the Administrator in policy development, ensuring CMS’ implementation of legislation is consistent with Congressional intent. (OL) |
| |Respond to Congressional calls received by OL in a timely manner. (OL) |
| |Announce CMS policies and decisions to Congress, in a timely manner. (OL) |
| |Maintain good relationships with Congressional staff and Members, by holding monthly meetings with Committee staff. (OL) |
| |Monitor and report on legislative activities affecting CMS programs to OA on a weekly basis. (OL) |
| |Develop Risk Adjustment for Prescription Drug Payment. (ORDI) |
| |GPRA Goals: N/A |
| |PART Milestones: N/A |
| |PMA: N/A |
| |FY 2006 JUSTIFICATION OF ESTIMATES FOR APPROPRIATIONS COMMITTEES - GOVERNMENT PERFORMANCE AND RESULTS ACT OF 1993 |
| |MEDICARE PROGRAM: |
|1 | Improve Satisfaction of Services Received (239) |
|2 | Improve Medicare's Administration of Beneficiary Appeals Process (242) |
|3 | Implement the New Medicare Prescription Drug Benefit (248) |
|4 | Decrease Prevalence of Restraints in Nursing Homes (250) |
|5 | Decrease Prevalence of Pressure Ulcers in Nursing Homes (253) |
|6 | Assure Quality, Value and Performance in Survey and Certification Activities (256) |
|7 | Improve Beneficiary Telephone Customer Service (258) |
|8 | Sustain Medicare Payment Timeliness (260) |
|9 | Increase Use of Electronic Commerce/Standards in Medicare (262) |
|10 | Maintain CMS' Improved Rating on Financial Statements (265) |
|11 | Improve Effectiveness/Dissemination of Medicare Info to Beneficiaries (273) |
|12 | Improve Understanding of Basic Features of Medicare Program (275) |
|13 | Implement Medicare Contracting Reform (278) |
|14 | Develop/Implement IT Architecture (280) |
|15 | Strengthen/Maintain Diversity at all Levels of CMS (288) |
|16 | CMS Research Investment and Program Improvements (294) |
|17 | Improve CMS' Information Systems Security (296) |
|18 | Implement Regional PPOs (299) |
| |QUALITY IMPROVEMENT ORGANIZATIONS: |
|1 | Beneficiaries Age 65+/Increase Flu and Pneumococcal Shots (304) |
|2 | Beneficiaries Age 65+/Increase Mammography (308) |
|3 | Diabetic Beneficiaries/Increase Rate of Diabetic Blood Testing (312) |
|4 | Reduce Frequency of Surgical Site Infection (314) |
|5 | Improve Vascular Access for Hemodialysis (317) |
| |MEDICARE INTEGRITY PROGRAM: |
|1 | Reduce Improper Payments/Medicare Fee-For-Service Program (328) |
|2 | Improve Provider Enrollment Process (330) |
|3 | Improve Effectiveness of Administration of MSP (332) |
|4 | Reduce Medicare Contractor Error Rate (335) |
|5 | Decrease the Medicare Provider Compliance Error Rate (337) |
| |GRANTS TO STATES FOR MEDICAID/MEDICAID AGENCIES: |
|1 | Improve Health Care Quality: Medicaid/SCHIP (350) |
|2 | Reduce Medicaid Payment Error Rates (355) |
| |STATE CHILDREN'S HEALTH INSURANCE PROGRAM: |
|1 | Decrease Number of Uninsured Children (359) |
| |STATE GRANTS AND DEMONSTRATIONS: |
|1 | Improve TWWIIA Accountability through Reporting (364) |
| |CLINICAL LABORATORY IMPROVEMENT AMENDMENTS: |
|1 | Improve and Sustain Testing Accuracy in Labs/Certificate of Waiver (370) |
| | |
| |* Number in parentheses refers to page in the FY 2006 Congressional Justification. |
|FY 2006 Operating | | | |
|Plan & FY 2007 | | | |
|Budget Request - | | | |
|(insert name of | | | |
|funding account) | | | |
| | | | |
Description:
Justification:
FY 2006:
Priority: _____ of _____
Performance Goal/Anticipated Accomplishment (including Legislative Initiative):
( 10x10 Goal (__________)
( GPRA Goal (__________)
Consequences if not funded:
Reason for increased/decreased funding request:
FY 2007:
Priority: _____ of _____
Performance Goal/Anticipated Accomplishment (including Legislative Initiative):
( 10x10 Goal (__________)
( GPRA Goal (__________)
Consequences if not funded:
Reason for increased/decreased funding request:
Project ____ — Activity/Project Title (Source of Funding)
(Provide the number of the activity/project. If new, enter “New.” Provide the source of funding, i.e., Medicare Operations, Medicare Integrity Program, Research, Federal Administration, etc.)
|FY 2005 |FY 2006 |FY 2006 |FY 2007 |
|Approved (02/28/05) |President’s |Total |Total |
| |Budget |Component |Component |
| | |Request |Request |
| | | | |
Description:
(Provide a short paragraph that explains the activity being requested.)
Justification:
(Provide a short paragraph that explains why this activity is important to the agency.)
FY 2006:
Priority: _____ of _____
(If a component has 10 individual projects, the first (highest) priority would be reflected as Priority: 1 of 10; the second priority would be Priority: 2 of 10; the last (lowest) priority would be Priority: 10 of 10. Existing and new projects will be ranked together in priority order.)
Performance Goal/Anticipated Accomplishment (including Legislative Initiative):
(List at least one GPRA goal and at least one 10x10 Department-wide Management and Program Objective that this activity/project falls under. In addition, provide the legislative mandate and section number (i.e., MMA, BBA, BBRA, BIPA, HIPAA, NHOIP) if known. Include a brief description of workload and/or outcomes that will be accomplished by this project.)
Consequences if not funded:
(Provide a short paragraph of the ramifications to the agency if this activity is not funded.)
Reason for increased/decreased funding request:
(If this is a currently funded activity, provide an explanation for any funding increase/decrease from current funding.)
FY 2007: (*See notes above for FY 2006.)
Priority: _____ of _____
Performance Goal/Anticipated Accomplishment (including Legislative Initiative):
Consequences if not funded:
Reason for increased/decreased funding request:
TRAVEL PURPOSE CODE DEFINITIONS
FY 2005/FY 2006/FY 2007
A1 – ADMINISTRATIVE SIMPLIFICATION (e.g., HIPAA)
• Provide outreach to providers on administrative simplification, security, and privacy.
• Conduct market reviews at the home offices of health insurers serving at least five States.
• Visit State insurance commissions regarding HIPAA.
• Meet with insurers and regulators in every State where CMS has direct enforcement authority.
• Provide technical assistance to the States regarding the application of HIPAA insurance reforms.
• Includes all HIPAA enforcement activities.
B1 – BENEFICIARY OUTREACH
• Meet with beneficiaries to share information and work collaboratively on issues of common interest.
• Provide outreach to other groups such as employers, unions, etc., including non-provider outreach activity.
• Provide training and conduct outreach activities with information, counseling, and assistance groups and other volunteer groups.
• Participate in NMEP Activities.
• Participate in REACH, partnership development activities, flu and mammography campaigns, etc.
• Conduct outreach to local Congressional offices.
• Includes other beneficiary service activities.
C1 – CLIA
• Investigate complaints against laboratories.
• Validate accuracy of State agency performance of CLIA programs
• Includes quality oversight of State agency exemption performance.
C2 – CONGRESSIONAL FIELD HEARINGS
• Includes all Congressional field hearing-related travel.
C3 – CPE – TEAM REVIEWS
• CPE is an essential component of CMS’ oversight of Medicare fee-for-service contractors. The CPE process includes CMS’ evaluation of Medicare contractors to ensure their compliance with performance requirements. The National CPE strategy contains CMS’ approach for conducting CPE and all planned CPE reviews to be conducted in a given fiscal year.
• Use this purpose code for CPE reviews that are determined necessary during the fiscal year that were not included in the National CPE strategy approved at the start of the annual review cycle. These “unanticipated” reviews may be necessary due to performance problems that occur during the year and other unforeseen situations that merit an onsite evaluation of the Medicare contractor.
• Includes CPE reviews by RO/CO multi-regional teams to achieve increased objectivity and consistency in the CPE process.
E1 – ESRD ACTIVITIES
• Provide technical assistance and guidance to ESRD networks on local, regional, and national Health Care Quality Improvement projects and quality initiatives.
• Conduct on-site visits to monitor and evaluate the ESRD networks.
• Participate in GTL-related travel associated with information sharing, contract issues, and presentations.
• Meet with provider groups, professional associations, stakeholder, partners, and beneficiary representatives to describe elements of program, disseminate results of and advances in health care quality improvement or other CMS initiatives, and keep abreast of major developments in the field.
• Develop operational policies/guidance for National program.
• Conduct training sessions provided by/for ESRD/CMS on ESRD activities.
• Travel to update/advise/problem solve issues/activities related to ESRD activities.
• Includes contractor paneling and reviews.
H1 – HIGLAS
• Includes all HIGLAS-related travel.
I1 – INFORMATION TECHNOLOGY ACTIVITIES
• Includes travel for IT activities only. (Limited use in the Regions.)
M1 – MEDICAID FINANCIAL MANAGEMENT ACTIVITIES
• Conduct quarterly reviews of State Medicaid budgets (CMS Form 37) and expenditures (CMS Form 64) and financial management reviews to ensure that federal requirements are met prior to reimbursement.
• Perform in-depth special financial management reviews of new, material, or sensitive costs areas and/or financial systems.
• Review Medicaid disproportionate share hospital (DSH) payments.
• Review Medicaid State and local administrative cost allocation plans and revisions.
• Defer questionable Medicaid costs and disallow unallowable Medicaid costs.
• Includes all Medicaid financial activities and all SCHIP financial management activities.
M2 – MEDICAID PROGRAM ACTIVITIES
• Provide technical assistance to the States on the development of approvable State plan amendments.
• Conduct monitoring reviews and provide technical assistance on Medicaid program issues in the State.
• Review State, local, contractor, and provider records to clear and close Office of the Inspector General and other audit reports.
• Participate in fraud and abuse activities at State Medicaid agencies.
• Conduct in-depth investigations, as required, into the operations of Managed Care contractors suspected of fraudulent activity or repeated regulatory noncompliance.
• Provide technical assistance to the States regarding 1915(b) or 1115 waivers and conduct pre- and post-implementation reviews of these waivers.
• Conduct assessments of the effectiveness of approved waivers prior to renewal.
• Includes all SCHIP program-related activities and all NAR visits.
M3 – MEDICARE APPEALS
• Conduct contractor meetings for training and provide technical assistance.
• Includes activities related to the transfer to the SSA ALJ workload, QIC activities, and activities related to first-level appeals processed by FI/carriers and second-level appeal work remaining at FI/carriers until completion of QIC transition.
M4 – MEDICARE CONTRACTOR OVERSIGHT
• Conduct contractor meetings for training and quality improvement.
• Provide policy/technical assistance on program safeguard activities.
• Provide oversight on contractor budgets.
• Conduct contractor financial review as part of the Chief Financial Officer’s (CFO) Act (e.g., 750/751, 1522, and internal control reviews).
• Conduct risk assessment review of a contractor’s final administrative
cost proposal (FACP).
• Provide oversight on provider audit and reimbursement issues, bankruptcies/ overpayments, and contractor budgets.
• Includes activities associated with Medicare contractor oversight and management (except CPE) and all Medicare financial management (except HIGLAS) .
M5 – MEDICARE CONTRACTOR TRANSITION
• Evaluate and monitor activities associated with contractor transitions to ensure a smooth conversion to a new claims submission protocol.
• Participate in meetings associated with contractor transitions, including interfacing with the professional societies and Congressional offices.
M6 – MEDICARE INTEGRITY PROGRAM ACTIVITIES
• Participate in fraud and abuse training sessions.
• Provide technical assistance on special fraud and abuse related projects.
• Conduct management and/or engagement review of the intermediary’s audit and settlement activities as specified by the Audit Quality Review Program (AQRP).
• Conduct conferences/meetings to perform training on Medicare secondary payer (MSP) activities.
• Participate in national MSP forums relating to MSP issues and policies.
• Visit bi- and tri-regional contractor medical director meetings to develop local medical review policy.
• Provide technical assistance to Medicare contractors in the areas of medical review, policy development, E&M reviews and special studies, and education of problem providers.
• Includes MSP, medical review, cost report audit, benefit integrity activities (including CERT and DAVE project activities), all GTL-related travel for PSC, travel related to PSC transitions, other program integrity/benefit integrity related program issues, special MSP-related projects as required by CMS (RO/CO management).
M7 – MEDICARE MANAGED CARE ACTIVITIES
• Develop operational policies.
• Speak to professional, beneficiary, academic, and industry groups about Medicare Managed Care.
• Monitor current Medicare Managed Care organizations and conduct focused reviews, when necessary, in the areas of quality of care member services, provider accessibility, claims processing, marketing, provider contracting, and fiscal soundness.
• Work with Medicare Managed Care contractors to provide technical assistance and guidance on QISMC and conduct on-site reviews of Medicare Managed Care contractors’ implementation of QISMC.
• Conduct in-depth investigations, as required, into the operations of contractors suspected of fraudulent activity or repeated regulatory noncompliance.
• Review new applicants for Medicare Managed Care contracts.
• Conduct reviews of service area expansion applications.
• Includes training sessions provided by/for the industry on Medicare Managed Care activities, FFS and PPO plans, and other educational and outreach activities.
M8 – MEDICARE FFS POLICY DEVELOPMENT (NON MMA)
• Consult with/meet with providers, associations, congressional staff, etc, on the development of Medicare policies and/or coverage issues.
• Medicare policy advisory committee travel.
MA – MMA/DRUG CARD
MB – MMA/PRESCRIPTION DRUG BENEFIT
MC – MMA/REGULATORY REFORM
MD – MMA/CONTRACTING REFORM
ME – MMA/FEE-FOR-SERVICE IMPROVEMENTS
• Actuarial, QIO, Research and Demonstrations, etc.
MF – MMA/ALL OTHER PROVISIONS (Central Office only)
• Agency-Wide Activities: IT System Changes, Public Affairs, Human Resources, etc. (Applicable only when no other code defines the travel purpose.)
N1 – NON-MMA/ALL OTHER PROVISIONS (Central Office only)
• Agency-Wide Activities: Public Affairs, Human Resources, etc. (Applicable only when no other code defines the travel purpose.)
P1 – PROGRAM LEADERSHIP
• Participate in Administrator, Center/Office Director, Regional Administrator/ Associate Regional Administrator meetings directly related to leadership activities.
• Participate in high-level meetings and retreats in support of Administrator and Secretary initiatives for which CMS has the lead or co-lead or is a participant.
• Participate in short-term details of staff and managers from one central office/ regional office to another to handle short-term staffing shortages or to provide multi-CMS opportunities
• Participate in meetings to discuss process improvement, workload consolidation, union issues, and further implementation plans.
• Participate in combined work planning/strategic meetings or seminars.
• Includes all Regional Administrator travel. (All program related meetings/conferences should be aligned with the function they support.)
P2 – Medicare FFS Provider Outreach/Education/Assist (Non MMA)
• Meet with providers and professional associations to share information and work collaboratively on issues of common interest.
• Includes all provider services travel (non-HIPAA).
• Provide technical assistance on existing FFS policy.
Q1 – QIOs
• Provide technical assistance and guidance to QIOs on local, regional, and National health care quality improvement projects and quality initiatives.
• Conduct on-site visits to monitor and evaluate the QIOs.
• Participate in GTL-related travel associated with information sharing, contract issues, and presentations.
• Travel to support public reporting initiatives such as the hospital quality initiative.
• Meet with provider groups, professional associations, stakeholders, partners, and beneficiary representatives to describe elements of the program, disseminate results of and advances in health care quality improvement or other CMS initiatives, and keep abreast of major developments in the field.
• Develop operational policies/guidance for National program.
• Attend training sessions provided by/for QIO/CMS on QIO activities.
• Travel to update/advise/problem solve issues/activities related to QIO activities.
• Participate in contractor paneling and reviews.
R1 – RESEARCH AND DEMONSTRATIONS- NON-MMA
• Participate in competitive bidding projects for a variety of Medicare services.
• Coordinate between CO/RO staff on demonstration projects. (Limited use in the Regions.)
R2 – RECLAIMS
• Reclaims claimed through HTS using a Local Voucher.
S1 – SURVEY & CERTIFICATION (includes Organ Procurement)
• Conduct State agency performance reviews.
• Conduct quality oversight of hospitals, nursing homes, home health agencies, hospices, and all other facilities where services are provided to Medicare and Medicaid beneficiaries.
• Travel to assist survey agencies in the development of State individual quality improvement plans. Activities associated with this include: (1) the establishment of baseline data; (2) training; (3) collaboration with provider and advocacy groups; (4) development of quality improvement plans; (5) monitoring reviews and technical assistance; and (6) budget negotiation and oversight.
• Conduct bi-annual surveys of OPOs and investigate complaints against hospitals.
• Conduct training sessions on OPO policies.
• Includes survey training, all other survey work (non-nursing home surveys, all certification work, conferences, etc.), and OPO coordinator travel.
S2 – SURVEYS – MANDATORY LONG-TERM CARE (Only 5% Surveys)
• Follow Social Security Act mandates that 5% of all long-term care facilities are surveyed by State survey agencies and receive Federal monitoring surveys (FMS).
• Conduct FMS and on-site surveyor performance assessment and training surveys (OSPATS). (These types of surveys generally require two to four Federal inspectors per survey.)
S3 – SURVEYS OTHER (Includes 1%, 2%, and Direct)
• Support CMS efforts to insure that State survey agencies are properly conducting surveys of all other provider types; specifically, CMS protocol dictates that 1% of all other providers surveyed by State survey agencies receive Federal monitoring surveys. (Although not statutorily mandated, the survey’s purpose is important.)
• Respond to numerous media allegations and Congressional/individual complaints. (CMS must be able to dispatch Federal survey teams on short notice to determine whether quality of care is being maintained. Also, Federal survey teams must, by statute, be available to survey State-owned and/or operated facilities. In instances where there is no approved State survey agency, it is the responsibility of the regional offices to survey participating facilities and initial applicants for compliance with program requirements.
• Includes FOSS, comparative surveys, and complaint surveys.
T1 – TRAINING/STAFF DEVELOPMENT
• Conduct or attend training courses associated with developing and improving agency-wide staff performance.
• Includes all travel for management training, CEG and PMI training, and career development training (program training should be reported under the program it supports).
T2 – TRIBAL AFFAIRS
THESE TRAVEL PURPOSE CODES ARE FOR NON-MMA TRAVEL (EXCEPT FOR CODES MA THROUGH MF).
MMA TRAVEL IS INCLUDED EXCLUSIVELY IN CODES MA THROUGH MF.
TOTAL: 33 Travel Purpose Codes
**New Travel Codes for FY 2005: M8, N1, P2 (word revision only)
THE CMS FY 2006 AND FY 2007 LEARNING PLANS
CMS has begun the process of planning and budgeting for training for FY 2006 and
FY 2007. Centers, Offices, and Regional Offices should assess their learning needs for the upcoming fiscal years and complete the form provided at Attachment A. Your requests for all training and learning activities must be listed in priority order on Attachment A.
Instructions for Completing Attachment A—Planned Learning Activities for FY 2006
Column A (Title of Learning Activity) - Use the numbering system in Attachment B to designate the specific learning activities. For example, fill in “3.d.” to indicate a Basic Writing Skills class or “2.f.” for Basic Project Officer Training. We want to eliminate the use of many different titles for the exact same class. If you want to add to your list a class that is not identified in Attachment B, you should put the title of the class in this column.
Column B (2005 Project Number or NEW) - If the same learning activity was requested and approved for FY 2005, provide the Project Number listed on Attachment C. If this is a new learning activity, write the word “NEW.”
Column C (Category) - Indicate whether the learning activity falls under 1 (Leadership and Management Skills), 2 (Technical and Professional Skills), or 3 (General Business Skills). (See Attachment B.)
Column D (Target Audience) - Describe the target audience, the potential number of people to be trained, their component(s), their job functions, and any other descriptors of the participants.
Column E (Justification) - Provide a full justification for the learning activity to be funded. For example, if the skill supports an HHS goal, include the goal, why the skill/knowledge is necessary for enhancing or meeting the goal and how accomplishment of the goal depends on the training. Describe the consequences if the learning activity is not funded. If you know the method of learning, indicate what it is (e.g., classroom training, conference or workshop, web-based, or other).
Column F (Estimated Training Cost) - Estimate total training costs. If the training cost is more than $25,000, a detailed explanation of the estimate is required in the justification field.
Column G (Estimated Travel Cost) - Estimate any travel costs associated with each of the proposed training events. This information should also be included on your travel worksheet for the FY 2006 Operating Plan.
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Columns H, I, and J (Decision Matrix) -
• Link to 10 X 10 - If the training is directly linked to the HHS 10 X 10 goals, list the specific goal number with which it is associated, for example “P-2” to indicate Program Goal 2 or “M-3” to indicate Management Goal 3.
• Required by Law, Reg , or CMS Policy - Answer “Yes” or “No.”
• Administrator’s Priority - List the number of the Administrator’s Priority from Attachment D (A.1 through A.5).
Column K (Point of Contact) - Include the name and phone number of the primary person coordinating this learning activity.
Column L (Priority Order) - List the priority from 1(highest) to last number (lowest). There can be only one highest priority, one second highest priority, etc. for each CMS Office, Center and Regional Office.
You do not need to identify specific learning activities for FY 2007 at this time. However, if you are aware of any general or special learning needs in FY 2007, please let us know now.
If you have any questions about completing Attachment A, you may contact Harry Kessler of the OOM/Learning Resources Group at 410-786-3009 or by email at HKessler@cms.
Managers in Central Office are encouraged to contact Angie Haggens at extension 65632 or LaVerne Gilmore at extension 65565 for assistance with refining their requests, selecting appropriate learning methods, or estimating costs. Managers in the Regional Offices may contact their Regional Training Coordinator for similar information.
Information on methods of learning and sources of training can be accessed on the CMSnet at as an aid in preparing requests.
4 Attachments
Attachment A—Planned Learning Activities for FY 2006.xls (See Attachment #7)
Attachment B—CMS Learning Categories for FY 2006 and FY 2007
Attachment C—Project Numbers for Approved FY 2005 Learning Activities (See Attachment #7)
Attachment D—Administrator’s Priorities
ATTACHMENT B: CMS Learning Categories for FY 2006 and FY 2007
1. Leadership & Management Skills
Definition: Includes programs for the development of leadership skills in non-supervisory employees and supervisory skills in management employees. The required curriculum for all new managers is included under this category. In addition, consulting services for organization development activities (such as team building, strategic planning, and business process improvement) and meeting facilitation services are included.
Learning Activities:
1. a. Proactive Leadership Skills for Non-Managers (GS-5 to GS-10)
1. b. Dimensions of Leadership for Non-Managers (GS-11 to GS-15)
1. c. Leadership in Context (required for new managers)
1. d. Advanced Leadership Program
1. e. Nuts & Bolts of Supervision (required for new managers)
1. f. Labor Relations for Managers (required for new managers)
1. g. Creating & Sustaining Partnerships
1. h. Executive / Management Coaching
1. i. Council for Excellence in Government (CEG) Fellows Program
1. j. Mentoring Program for Managers and Executives
2. Technical & Professional Skills
Definition: Includes continuing education for CMS’ professional staff (such as nurses, clinicians, surveyors, certified public accountants, actuaries, economists, statisticians), basic and advanced Project Officer training for Government Task Leaders, specific program training related to components’ functional responsibilities, and technical information technology (IT) skills.
Learning Activities:
2. a. Continuing Education for Nurses and Clinicians
2. b. Continuing Education for Medical Doctors
2. c. Continuing Education for Surveyors
2. d. Continuing Education for Accountants
2. e. Continuing Education for Actuaries
2. f. Continuing Education for Other Professionals (specify the profession)
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2. g. Basic Project Officer Training
2. h. Advanced Project Officer Training
2. i. Refresher Training for Project Officers and Government Task Leaders
2. j. HIPAA Education
2. k. Call Center Operations
2. l. Security/Emergency Management
2. m. Auditing Training
2. n. EEO & Civil Rights Training for Professionals
2. o. HIPAA Security, NPI & Electronic Codes
3. General Business Skills
Definition: Includes the general business skills necessary to be a successful and productive CMS employee. This category includes the New Employee Orientation Program, basic program education for all employees, communication skills, desktop personal computer applications, analysis skills, mentoring programs, tuition assistance programs, and distance learning.
Learning Activities:
3 .a. Project Management
3. b. Financial Management
3. c. New Employee Orientation Program
3. d. Basic Writing Skills
3. e. Advanced Writing Skills
3 .f. Basic Analysis Skills
3. g. Advanced Analysis Skills
3. h. Briefing and Presentation Skills
3. i. Public Speaking
3. j. Problem Solving and Decision Making
3. k. Tuition Assistance Programs
3. l. HHS Mentoring Program (GS-5 to GS-12)
3. m. MS Word
3. n. MS Excel
3. o. MS Access
3. p. MS PowerPoint
3. q. MS Outlook
3. r. MS Project
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ATTACHMENT D: Administrator’s Priorities
A. 1. Paying Appropriately, Accurately and Effectively for Health Services
This theme covers a wide range of on-going activities.
• The efficient and effective continuation of day-to-day operations at the carriers and fiscal intermediaries (e.g., processing claims timely and accurately, responding to providers’ and beneficiaries’ inquiries, handling appeals, educating providers and beneficiaries) as well as their focused program integrity efforts (i.e., provider audits, debt referral and collection, benefit integrity, and medical review) and the use of the competitive reforms in carrier and FI contracting to improve accuracy, timeliness and responsiveness of claims processing;
• The efficient and effective continuation of operations related to managed care plan payments and IGT payments;
• CMS’s efforts to ensure that Medicare policies appropriately reflect what services should be reimbursed and how much (e.g., Prospective Payment System-PPS);
• CMS’s activities to implement HIPAA administrative simplification provisions, including the electronic transactions and code sets provision and the unique identifiers for providers and health plans;
• CMS’s ability to get the necessary infrastructure (i.e., IT, staff, regulations, program manuals and instructions) in place to ensure effective claims payment and financial management for the new prescription drug discount card and drug benefit provisions of the MMA and to successfully implement the contracting reform provisions of the MMA;
• CMS’s ability to maintain an unqualified opinion (clean opinion) on our financial statements; or
• CMS’s ability to implement the Medicare Secondary Payor Comprehensive Plan to recover significant resources for the Trust Funds.
A. 2. Driving Improvements in Quality of Care and Health Outcomes
This theme focuses on the premise that CMS is not just a claims processor. It is a public health agency that can improve the quality of health care delivery for all of its beneficiaries through innovation and research. The six dimensions of quality – safety, efficiency, effectiveness, patient-centered and equity – are central to CMS’s quality improvements.
• CMS quality improvement strategy/initiatives involving all of our health provider partners – the Nursing Home Quality initiative, the Home Health Quality initiative, the recently-announced quality guidelines for Hospitals and the Physician Focused Quality initiative;
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• Development of a quality improvement strategy for beneficiaries that entails making Medicare more personalized;
• CMS’s initiatives to improve beneficiary health, including education about benefits, choices and steps that beneficiaries can take to maintain and improve their health (e.g., educational campaigns about flu vaccines, mammograms, etc);
• CMS’s understanding and improvement of the incentives created by our payment systems for delivering health care efficiently, which requires considering how health care organizations will respond to payment rules, monitoring trends in spending, utilization, and quality of care provided in a timely way to determine the behavioral and public health consequences of our payment policies and understanding whether they are having an undesirable effect on medical practices and patient outcomes;
• Innovative demonstrations, such as coordinated care, chronic disease management, lifestyle modification, physician group practice, health promotion demonstrations and evaluations and the care management performance demonstration authorized by Section 649 of the Medicare Modernization Act;
• Electronic initiatives, such as helping to develop electronic standards and encouraging their use, e-prescribing to reduce preventable prescription errors and encouraging the adoption of electronic health records and an electronic health information infrastructure for both processing claims and delivering care;
• Numerous activities carried out on CMS’s behalf by the Quality Improvement Organizations (QIO’s) and the State Survey and Certification Agencies;
• Initiatives to improve the quality of care for Medicaid beneficiaries, including children under SCHIP, through activities such as the Home and Community Based Services (HCBS) workbook; or
• Coordination with other Departmental, Administration and international efforts to improve quality of care.
A. 3. Partnering with Our Stakeholders
This theme focuses on the things CMS is doing to strengthen its partnerships and relationships with beneficiaries, providers, technology developers, managed care plans, Congress, the states, medical associations, law enforcement agencies, advocacy groups and other stakeholders.
• Improvement of quality and reduction of costs in health insurance programs;
• Reduction of the regulatory burdens on providers (e.g., PRIT and the Secretary’s Advisory Committee on Reform);
• CMS’s initiative to become more open and accessible (e.g., open-door forums, particular “lead” agency components to assure effective input and outreach for each partner group);
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• The streamlining of CMS’s processes to make it easier to do business with us (e.g., new provider and supplier enrollment process);
• The use of technology for easier access (e.g., accepting electronic comments on proposed Medicare and Medicaid regulations);
• CMS’s ability to work with states to identify successful, legal approaches to reduce Medicaid and SCHIP costs while maintaining or improving quality of care and assisting other states in adopting these evidence-based approaches (e.g., generic drug substitution, some disease/case management programs, negotiations with drug manufacturers instead of relying on Medicaid price regulations alone);
• CMS’s ability to work with states to educate Medicare beneficiaries (e.g., through the State Health Insurance Assistance Programs (SHIP’s)) to promote community living for the disabled (e.g., through Real Choice Systems Change grants) and to address the shortage of direct care workers (e.g., through the New Freedom Initiative);
• CMS’s partnership with other government agencies to combat fraud and abuse, such the Department of Justice (e.g., Operation Wheeler Dealer), SSA or Treasury (e.g., Medicare Secondary Payor); or
• The establishment of new ways of partnering with organizations to reach out to beneficiaries (e.g., the long-term care initiative that CMS has entered into with AoA).
A. 4. Managing the Evolution of Our Programs Strategically
This theme envisions the development of medium- and long-range sets of performance objectives that assure that our short-term activities can be tracked and their performance evaluated and that address pending economic and social changes and their impact on CMS. A prime example of is the aging of the baby-boom generation and the accompanying workload and financing issues that will emerge as this cohort becomes eligible for Medicare and, potentially, for long-term care financed by Medicaid. Additionally, as part of this theme CMS will develop a capital investment strategy and process to ensure that decisions regarding capital investments considers the short and long-term programmatic, operational and funding needs.
• Participation in the Agency’s effective application of OMB’s Program Assessment Rating Tool (PART), the activities to implement OMB’s recommendations for CMS program improvements, or the activities to support implementation of the President’s Management Agenda (PMA) and Government Performance and Results Act (GPRA);
• Budget and performance integration (e.g., integrating budget formulation and execution in the Agency’s budget call letter process and integrating financial and performance information to make decision about the management of CMS programs.);
• CMS’s capability to ensure that our systems infrastructure is capable of handling the increased demand and complexity generated by the baby-boomers without disruptions in service (e.g., Revitalization Plan, HIGLAS, CWF Redesign, claims processing and database modernization, systems security and other IT investments);
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• CMS’s provision of adequate communication and education to all affected parties (e.g., NMEP);
• CMS’s ability to make Medicaid more flexible (e.g., LIFE accounts), explore options blending public and private insurance (e.g., Partnership for Long-Term Care, HIFA waivers) and address the needs of the dual eligible population (e.g., various dual eligible demonstrations);
• CMS’s understanding of the disparities in health care among minority populations and efforts to ensure that the provider community is able to meet the needs of the diverse populations in our country (e.g., the cancer prevention demonstration, CMS’s grant programs for Historically Black Colleges and Universities and Hispanic researchers);
• CMS’s ability to measure impact of new technology on health and quality of life; or
• CMS’s assessment of impact of prescription drug coverage on health and quality of life.
A. 5. Promoting Strong Organization Health
This theme addresses CMS’s efforts to assure that it is developing and maintaining the organizational capabilities it needs to carry out our increasingly complex and important mission, while ensuring the workforce is highly performing and accountable.
• CMS’s investment in and development of its human capital, including the development of the next generation of CMS leaders and managers (e.g., the Leadership/Management Development Strategy), training of new and existing staff, identification of needed skill sets, efforts to ensure that the workforce is diverse, elimination of existing gaps in critical skills sets (e.g., Clinical Workforce Strategy), projections of upcoming retirements and planning for succession (e.g., the CMS Action Plan), recruitment of staff with the right skills to implement MMA or evaluation of space and equipment needs to accommodate increased staff;
• Business process planning, which ensures that the Agency’s business processes are both efficient and reflect the Agency’s key strategic goals and business activities, including the identification and mitigation of risks;
• The management of core business operations, including the securing of resources to ensure that operations are adequately managed and designed to achieve the programmatic objectives of the agency; or
• The effective implementation of management initiatives, including the President’s Management Agenda activities and key Departmental initiatives, to ensure that the Agency is using its limited resources efficiently;
|Component or Region: | | | | | | | | | | |
|Group/Division: | | | | | | | | | |
| | | | | | | |Link to|Required by |Administrator's Priority | |
| | | | | | | |10X10 |Law, Reg, or| | |
| | | | | | | | |CMS Policy | | |
| | | | | | | | |
| |
|ATTACHMENT C: Project Numbers for Approved FY 2005 Learning Activities |
| | | |
|FY 2005 |Comp. |Activity/Project |
|Project | | |
|No. | | |
|9113 |CMS |Component Discretionary (Per capita) |
| | | |
| | |Continuing Education |
|9603 |CBC |CPE for CPAs |
|9602 |CMSO |CPE-Surveyors |
|9680 |OACT |Quality of Actuarial Estimates |
|9681 |OACT |CE for Statisticians/Economist |
|9614 |OCSQ |CPE-Nurses/Clinicians |
|9684 |OFM |CPE for CPAs |
|9670 |OAGM |Acquisition & Grants |
|9686 |RO |Consolidated: Accountants |
| | | |
| | |Communications |
|9630 |CMM |Journalism Training |
|9631 |OOM/LRG |Agency Writing (Consolidated) |
|9635 |RO |Consolidated: Technical Writing |
|9634 |RO I |Public Speaking |
|9636 |RO II |Presentation Skills |
|9637 |RO IV |Media Training |
|9638 |RO IV |Public Speaking |
|9639 |RO V |Public Speaking |
|9640 |RO VI |Communicating with Hard to Reach Populations |
|9642 |RO VIII |Public Speaking |
|9643 |RO IX |Advanced Briefing Techniques |
|9644 |RO X |Public Speaking |
| | | |
| | |Contract Management |
|9619 |OAGM/RO |Project Officer (Consolidated CMS-wide request) |
|9629 |RO |Consolidated: Acquisition management |
| | | |
| | |General Skills |
|9612 |OEOCR |Diversity & Civil Rights |
|9605 |OOM |Project Management |
|9611 |OOM/LRG |HHS Distance Learning |
|9610 |OOM/LRG |Problem solving (CMS-wide) |
|9613 |OOM/LRG |Career Professional Development |
|9659 |OOM/LRG |Tuition Assistance Program |
|9657 |OOM/LRG |HHS Mentoring Program |
|9658 |OOM/LRG |Employee Development Program |
|9641 |RO |Consolidated: Analysis Skills |
| | | |
| | |Information Technology Skills |
|9650 |CBC |Internet Fundamentals/Webmaster Assistance |
|9652 |CMSO |Component Specific IT Skills |
|9655 |OFM |Component Specific IT Skills |
|9653 |OIS |Component Specific IT Skills |
|9651 |OIS |Agency-wide IT skills (Web,SAS, Database) |
|9656 |RO IX |Information Security Regulations & Requirements |
| | | |
| | |Management and Leadership |
|9609 |OCSQ |Workforce Development |
|9601 |OOM/LRG |Leadership in Context |
|9604 |OOM/LRG |Creating and Sustaining Partnerships |
|9606 |OOM |Human Resource Management |
|9607 |OOM/LRG |Proactive Leadership Skills |
|9618 |OOM/LRG |OD Consult. & Facilitation |
|9615 |OOM/LRG |Executive Coaching |
|9649 |OOM/LRG |Management and Leadership Development |
|9668 |RO |Consolidated: Management/Leadership Training |
|9616 |RO |Meeting Facilitation |
|9620 |RO II |Proactive Leadership Skills |
|9621 |RO IV |Working with Diverse Populations and Groups |
|9625 |RO VIII |Team Building |
|9626 |RO IX |Proactive Leadership Skills |
|9627 |RO X |Proactive Leadership Skills |
|9628 |RO X |Diversity and Cultural Competence Training |
|9645 |RO X |Partnership Development Training |
|9617 |OOM |Presidential Management Intern |
|9649 |OOM |Master Labor Agreement |
| | | |
| | |Program Knowledge |
|9608 |CBC |HCCA Compliance |
|9632 |CBC |Call Center Operations |
|9660 |CBC |Social Marketing |
|9661 |CMSO |HIPPA Education |
|9646 |OCSQ |Rapid Cycle Improvement & Process Redesign Methods |
|9647 |OCSQ |Using Health Info Stand. To Enhance Assessment Instruments |
|9662 |OCSQ |Decreasing Waste and inefficiency |
|9663 |OEOCR |EEO and Civil Rights Training for Professionals |
|9683 |OFM |Budget Analysis/Accounting Management Courses |
|9664 |OHS |HIPPA & Electronic Health IT Opportunities |
|9665 |OHS |HIPPA Security, NPI & Electronic Trans. & Code Set Outreach |
|9666 |OOM/LRG |Training Development and Facilitation Skills |
|9654 |OOM |GSA/FTS Conference |
|9622 |OOM |Auditing Training |
|9623 |OOM |Security/Emergency Management |
|9624 |OOM |Aperture |
|9648 |ORDI |Econometrics/Research |
|9633 |OEA(PAO) |Annual Update for Media |
|9667 |RO |Consolidated: Program Knowledge |
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