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Cover Oregon Weekly status report covering week 3 For week ending May 30, 2014 Transition Project Director: Tina Edlund Senior Project Manager: Sarah Miller.

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Presentation on theme: "Cover Oregon Weekly status report covering week 3 For week ending May 30, 2014 Transition Project Director: Tina Edlund Senior Project Manager: Sarah Miller."— Presentation transcript:

1 Cover Oregon Weekly status report covering week 3 For week ending May 30, 2014 Transition Project Director: Tina Edlund Senior Project Manager: Sarah Miller Submitted by: Deloitte Consulting Submission Date: June 2, 2014 Version 1

2 Copyright © 2014 Deloitte Development LLC. All rights reserved. 1 Status Report for week ending May 30, 2014 Executive Summary Overall Status Rationale: Lack of direct access to OHA & Cover Oregon development/test environments through the end of Week 3 of the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system current state and re-usability of Cover Oregon functionality for MAGI Medicaid. Key Accomplishments Submitted Deliverable 3 – Status Report for Week 2 Submitted Deliverable Expectations Documents for: Web Presence, Security Strategy, Organizational Change Management Reviewed key financial rules for MAGI Medicaid Children’s Health Insurance Programs (MAGI Medicaid/CHIP) and documented gaps in the current Cover Oregon rule set Continued daily session with the team leads and approach alignment session with the team leads and Business Lead Coordinated End to End User Process Flow session Key Next Steps Submit the finalized set of 26 key MAGI Medicaid/CHIP scenarios to the Eligibility & Enrollment (EE) team for review and feedback Complete internal review of recommendations for all verification services Complete review of use cases, process flows and requirements with Modified Adjusted Gross Income (MAGI) Medicaid project stakeholders Validate the draft security requirements and prioritize for Nov Analyze and review canned reporting requirements for minimum Affordable Care Act (ACA) compliance for Nov [CMS and Determination State] Key Issues/Risks Lack of direct access to OHA development/test environments through the end of Week 3 of the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system current state State counterpart for Organization Change Management will not be on-boarded until June 3 Oracle contract scheduled to end on June 15, we need to assess whether this will have an impact of this relative to the overall scope R R G G Support MAGI Medicaid: Transition QHP to FFM: At Risk On Track

3 Copyright © 2014 Deloitte Development LLC. All rights reserved. 2 Status Report for week ending May 30, 2014 Cover Oregon – Status Report DashboardWeek ending May 30, 2014 #Key Deliverables % Complete Completion Date Sign-Off Date Status Workstream #1: Project Management 1.1 Project approach and staffing plan 100%May 14, 2014May19, Weekly status report covering week 1 100%May 19, 2014May 22, Weekly status report covering week 2 100%May 26, 2014May 29, Weekly status report covering week 3 90%June 2, 2014June 5, Weekly status report covering week 4 0%June 9, 2014June 12, Weekly status report covering week 5 0%June 16, 2014June 19, Final status report covering weeks 1-6 0%June 20, 2014June 25, 2014 Workstream #2: Transition QHP to FFM 2.1 QHP to FFM Roadmap 10%June 20, 2014June 25, 2014 Workstream #3: Support MAGI Medicaid 3.1 Web Presence Strategy In ProgressJune 18, 2014June 23, Security Strategy In ProgressJune 18, 2014June 23, Organization Change Mgmt (OCM) Strategy StartedJune 18, 2014June 23, Requirements Catalog 20%June 18, 2014June 23, MAGI Medicaid Roadmap 20%June 20, 2014June 25, 2014 G G G G N N N G G R R Y Y Status Legend G On Track N Not Started Y Needs attention R At risk of meeting timelines % Complete Legend 0% - Not Started50% - Half-way Complete90% - Submitted for Approval 10% - Started70% - Well Underway100% - Complete / Approved 20% - In Progress80% - Submitted for Review

4 Copyright © 2014 Deloitte Development LLC. All rights reserved. 3 Status Report for week ending May 30, 2014 Cover Oregon – Status Report DashboardWeek ending May 30, 2014 #Key Activities % Complete Status Workstream #1: Project Management 1 Definition of Project methodology, Project management approach, and anticipated staffing for activities within this SOW 100% 2 Planning, coordination, and weekly status reporting of activities within this SOW On-going 3 Daily oral briefings with Cover Oregon’s Contract Administrator On-going Workstream #2: Transition QHP to FFM 1 Development of a strategy roadmap for transitioning individual enrollment for Qualified Health Plans to Federally Facilitated Marketplace 20% Workstream #3: Support MAGI Medicaid 1 Scoping and recommendation of a strategy for interfaces 20% 2 Comparison of data models 20% 3 Requirements clarification and catalog update 20% 4 Development of a strategy for the web presence for the Medicaid Eligibility System Front End 10% 5 Hub On-Boarding Work & Bi-Directional Account Transfer Initiation Work 20% 6 Complete a Security Assessment/Establish Security Strategy 10% 7 Establish scope for organizational change management and training 0% 8 Establish scope for all types of testing 20% 9 Contingency planning for subsequent work 0% G G G G R Y R Y Y R N Y N Status Legend G On Track N Not Started Y Needs attention R At risk of meeting timelines % Complete Legend 0% - Not Started50% - Half-way Complete90% - Submitted for Approval 10% - Started70% - Well Underway100% - Complete / Approved 20% - In Progress80% - Submitted for Review

5 Appendix Status by Team

6 Copyright © 2014 Deloitte Development LLC. All rights reserved. 5 Status Report for week ending May 30, 2014 Status by Team Workstream #1: Project Management Team Accomplishments (prior week) Executed daily oral briefings with Cover Oregon’s Contract Administrator Facilitated daily session with the team leads Facilitated approach alignment session with team leads and Business Lead Coordinated End to End User Process Flow session Submitted Oracle resource needs to the state to support the team in lieu of environment access Coordinated Meeting schedule on SharePoint with State and Deloitte team leads Submitted Deliverable Expectations Documents for: Web Presence, Security Strategy, Organizational Change Management Initiated consolidation of project plan Coordinated remaining access gaps to State SharePoint site for all Deloitte resources On-boarded three additional Deloitte resources (per plan) and State team leads Prepared Deliverable 3 – Status Report for Week 3 for submission Upcoming Work (current week) Execute daily oral briefings with Cover Oregon’s Contract Administrator Coordinate work plan updates with State PMO Lead Coordinate conversion of Big Rocks issues tracker to SharePoint Prepare Deliverable 4 – Status Report for Week 4 for submission Issues/Risks Alternative approaches needs to be discussed to complete certain deliverables given lack of environment access and early roll off of Oracle resources Leads: David F./Annamarie B

7 Copyright © 2014 Deloitte Development LLC. All rights reserved. 6 Status Report for week ending May 30, 2014 Status by Team Workstream #2: QHP Transition to FFM Team Accomplishments (prior week) Plan Management Updated transition work plan to include input from Cover Oregon and Oregon Insurance Division Continued follow-up with CMS to obtain response to list of 20 questions previously sent for clarification on May 27, 2014 Conducted discovery of the transition implications to SHOP process Broker: Began discovery discussions with Broker/Agent contact to identify communication needs, business process changes Web based strategy – formulating Continued assessment of the Cover Oregon site to identify content needed to support the transition to Federally Facilitated Marketplace (FFM) Continued reviewing other FFM state sites to identify ideas for Oregon’s home page Began defining the user work flows for the Cover Oregon information pages, MAGI (Modified Adjusted Gross Income) Medicaid, and the FFM links Began reviewing available Portal solutions to support the MAGI Medicaid applications (Cover Oregon, Oregon Benefits Online, paper application) Began discovery and analysis of technical architecture in OHA e-Government Portal for hosting the public facing website and OHA’s Medicaid Application Upcoming Work (current week) Plan Management Review answers to questions submitted to CMS to help us understand end-to-end process and begin defining gaps (TBD) Review and update draft work plan to define activities required between current date and Nov. 2014, target completion Wednesday Discuss communication tools/process with the carriers Broker Continue identifying impacts to Broker/Agent relationships with Carriers and clients Web based strategy – formulating Begin creating site map of future capabilities for Oregon’s home page and other pages based on ideas gathered from other states and existing pages Continue assessment of the Cover Oregon site to identify content needed to support the transition to FFM Continue reviewing portal solutions to support MAGI Medicaid application (Cover Oregon, Oregon Benefits Online, paper applications…) Begin documenting critical success factors, assumptions and constraints – target execution date June 12 Issues/Risks Need state contact for Navigator track Leads: Chiqui F./Ivy B.

8 Copyright © 2014 Deloitte Development LLC. All rights reserved. 7 Status Report for week ending May 30, 2014 Status by Team Workstream #3: Application Intake & Case Management Team Accomplishments (prior week) Continued drafting of data crosswalk consisting of multiple system data fields and their respective alignments to understand current flow and consistency of data across current applications Conducted requirements validation session and finalized prep material comprised of: use case descriptions for Application Intake & Case Management process areas process flows for Application Intake & Case Management process areas initial requirements catalog and gaps for Application Intake & Case Management process areas, based on Cover Oregon and Oregon Health Authority (OHA) requirements documents, and categorized under following areas: Application Registration and Application Intake, Change in Circumstances, Manual Redeterminations, Complaints, Appeals and Hearings Upcoming Work (current week) Continue review of Cover Oregon and OHA Siebel application and available documentation Review existing OHA application functionality by walking through selected end-to-end use cases Complete development of requirements catalog Complete review of use cases, process flows and requirements with Modified Adjusted Gross Income (MAGI) Medicaid project stakeholders Validate the draft Application Intake & Case Management team requirements and prioritize for Nov Issues/Risks Lack of direct access to OHA & Cover Oregon development/test environments through the end of Week 3 of the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system current state and re-usability of Cover Oregon functionality Leads: Carol B./Yer V./Stephanie R.

9 Copyright © 2014 Deloitte Development LLC. All rights reserved. 8 Status Report for week ending May 30, 2014 Status by Team Workstream #4: Eligibility & Enrollment Team Accomplishments (prior week) Reviewed key financial rules for MAGI Medicaid Children’s Health Insurance Programs (MAGI Medicaid/CHIP) and documented gaps in the current Cover Oregon ruleset Reviewed 15 key MAGI Medicaid/CHIP scenarios and updated based on the team’s feedback Conducted gap analysis to determine gaps in Cover Oregon Noticing requirements vs. Affordable Care Act (ACA) required notices and came up with a list of must have noticing requirements for Nov Reviewed current Enrollment process and came up with a To-Be Enrollment process Cover Oregon/Oregon Health Authority (OHA) provided the current enrollment and noticing process to expedite our understanding Continued to analyze the process of commenting out rules not related to MAGI Medicaid/CHIP in the current Cover Oregon Ruleset Identified gaps in OHA data model vs. required data elements for eligibility determination and for storing eligibility determination results Upcoming Work (current week) Submit the finalized set of 26 key MAGI Medicaid/CHIP scenarios to the Eligibility & Enrollment (EE) team for review and feedback Submit a draft version of Eligibility, Enrollment and Noticing requirements to the EE team for review and feedback Submit a draft version of the To-Be Enrollment process to the EE team for review and feedback Review current noticing process flow and come up with a To-Be noticing process flow. Also, submit the finalized To-be flow for team review and feedback Complete the analysis of the process of commenting out rules not related to MAGI Medicaid/CHIP in the current Cover Oregon Ruleset Validate the draft Eligibility & Enrollment requirements and prioritize for Nov Issues/Risks None Leads: Joyce C./Vivian L./Praneet R.

10 Copyright © 2014 Deloitte Development LLC. All rights reserved. 9 Status Report for week ending May 30, 2014 Status by Team Workstream #5: Interfaces Team Accomplishments (prior week) Completed mapping of State Modified Adjusted Gross Income (MAGI) validation plan to existing verification services with current status of the implemented services & started internal review of the recommendations Continued building requirements catalog by incorporating the requirements from other states and Oregon HIX documents Started review of the Account Transfer Extensible Markup Language (XML) structures for different scenarios Started review of the Minimum Essential Coverage (MEC) business service definition (BSD) and use case scenarios Continued review of the Cover Oregon Siebel to Oregon Health Authority (OHA) Web Services to Medicaid Management Information System (MMIS) interface to understand the data flow and current status of the implementation Upcoming Work (current week) Complete internal review of recommendations for all verification services Continue to build requirements catalog by incorporating the requirements from other states, Oregon HIX documents and refine as needed Complete review of the Account Transfer XML structures for different scenarios Complete review of the MEC BSD and use case scenarios to refine requirements Continue to review the current process flow of Cover Oregon Siebel-OHA web service-MMIS interface to identify the functionalities that require changes to implement end to end MMIS enrollment Validate the draft Interfaces team requirements and prioritize for Nov Issues/Risks Lack of direct access to Cover Oregon development/test environments through the end of Week 3 of the assessment, is negatively impacting available time for Deloitte to make feasible assessment of re-usability of Cover Oregon verification interfaces Leads: Britt S./Sandeep C.

11 Copyright © 2014 Deloitte Development LLC. All rights reserved. 10 Status Report for week ending May 30, 2014 Status by Team Workstream #6: Security Team Accomplishments (prior week) Continued to review the polices and procedure shared by Oregon Health Authority (OHA) Chief Information Security Officer (CISO) office and security team in alignment with Center for Medicare and Medicaid Services (CMS) security requirements and documented the shortcomings Participated in meetings / interviews with OHA security team and Oracle to understand the existing security infrastructure and documented the gaps as per CMS requirements Participated in the initial call with CMS to identify the security deliverables and timelines in order to connect with the Federally-Facilitated Marketplace (FFM) services Obtained access to Identity & Access Management (IAM) environments for UDEV/FTS in Cover Oregon environment Submitted the Deliverable Expectation Document (DED) for security strategy deliverable as part of the current assessment Upcoming Work (current week) Continue to work with the CISO office and security team to complete the review of existing security policy and procedures and document the findings Document the findings and gaps identified in the OHA security infrastructure in-comparison to CMS requirements. Document the draft security roadmap for OHA MAGI Medicaid Validate the draft security requirements and prioritize for Nov Issues/Risks Lack of direct access to OHA & Cover Oregon development/test environments through the end of Week 3 of the assessment, is negatively impacting available time for Deloitte to make feasible assessment of OHA system current state and re-usability of Cover Oregon functionality Leads: Stefan R./Debi M.

12 Copyright © 2014 Deloitte Development LLC. All rights reserved. 11 Status Report for week ending May 30, 2014 Status by Team Workstream #7: Solution Architecture & Infrastructure Team Accomplishments (prior week) Coordinated with Oracle Cloud Management Services (OMCS) and Cover Oregon Security to determine process and grant access to Cover Oregon application environments for Deloitte team analysis activities Coordinated with OMCS and Oracle Consulting Service (OCS) on Oregon Health Authority (OHA) Training environment refresh in preparation for Deloitte team analysis activities Participated and provided input into the OHA Environment Strategy for the implementation phase Distributed OHA Siebel repository analysis report on customization and best practices to Rob, Peter, and Mark on 05/30 Participated in follow-up Web Presence Security Strategy session to align potential solutions across multiple teams Provided initial recommendation on leveraging Cover Oregon Fed Integrations for reuse and determined next analysis steps Upcoming Work (current week) Conduct session to review to-be High Level Solution Architecture draft with Solution Architecture team Review to-be Integration Security Strategy with Security Team and State Security Architects Provide inputs on detailed analysis on leveraging Cover Oregon Fed Integrations for reuse in OHA in conjunction with Security and Integration teams Develop refined Application Intake options in conjunction with Security, Application Intake, and Eligibility teams Address follow-up questions of OHA Siebel repository analysis report on customization and best practices Review and provide feedback into the Data Conversion strategy Finalize environment designation for Center for Medicare and Medicaid Services (CMS) Certificates for Hub Testing including specific environments to be used for hub testing, both formal and informal Issues/Risks Need access to Household Grouping design from OHA team to validate implications on assessment and inform the MAGI Medicaid Roadmap deliverable Leads: Rob T./Jeremy B.

13 Copyright © 2014 Deloitte Development LLC. All rights reserved. 12 Status Report for week ending May 30, 2014 Status by Team Workstream #8: Testing Team Accomplishments (prior week) Defined roles and responsibilities across the testing project team Identified source of test data Facilitated planning sessions to define scope for test environments Significant progress made toward acquisition and configuration of test tools Facilitated meeting with Track leads to estimate number of test scenario needed Upcoming Work (current week) Facilitate meeting for “come to agreement” about test environments Initiate discussion with CO test team to review CO test data and test scenario Facilitate discussion to define requirements for performance testing Meet with the OIS team that manages Application Lifecycle Management (ALM) to discuss requirements for use of ALM Make substantial progress on Testing Strategy document Meet with potential Section 508 testing resource Issues/Risks None Leads: David V./Dmitry K.

14 Copyright © 2014 Deloitte Development LLC. All rights reserved. 13 Status Report for week ending May 30, 2014 Status by Team Workstream #9: Reporting Team Accomplishments (prior week) Decision: Oregon Health Authority (OHA) database will be the only source for Reporting Identified some of the Centers for Medicare & Medicaid Services (CMS) reporting needs Received list of reports from Determination state (e.g. Montana) Confirmed reporting scope buckets Defined and reviewed the Approach for Reporting Assessment Added Melissa Hanks to the Reporting Team Upcoming Work (current week) Analyze and review canned reporting requirements for minimum Affordable Care Act (ACA) compliance for Nov [CMS and Determination State] Assess ad-hoc reporting requirements for minimum ACA compliance for Nov [Consumer Information and Insurance Oversight (CCIIO), Legislative and Operational] Follow up on Reporting Requirements documented in the Household Grouper Functional Design Document with Oracle Validate the draft Reporting team requirements and prioritize for Nov Issues/Risks Need access to Household Grouping design from OHA team to validate implications on assessment and inform the MAGI Medicaid Roadmap deliverable Leads: Chris B./Nancy R./Lali C.

15 Copyright © 2014 Deloitte Development LLC. All rights reserved. 14 Status Report for week ending May 30, 2014 Status by Team Workstream #10: Data Conversion Team Accomplishments (prior week) Participated in the data cross walk approach discussions Defined and reviewed the approach for Data Conversion assessment Initiated data elements identification on Data Conversion needs for Nov Data model for Cover Oregon (to be delivered end of week by Oracle) Upcoming Work (current week) Review data sources including application process for Data Conversion Confirm mandatory/conditional data elements from Federally Facilitated Marketplace (FFM) to Oregon Health Authority (OHA) data model Identify additional data elements from Cover Oregon to OHA Assess the usability of data Finalize Data Conversion scope Participate in Application Interface, Eligibility and Data Conversion end to end review process Issues/Risks Need access to Household Grouping design from OHA team to validate implications on assessment and inform the Modified Adjusted Gross Income (MAGI) Medicaid Roadmap deliverable Delay in access to Cover Oregon and OHA environments coupled with the access to Oracle resources has delayed the completion of Data mapping exercise; expected to be completed by end of week 4 Leads: Chris B./Nancy R./Lali C.

16 Copyright © 2014 Deloitte Development LLC. All rights reserved. 15 Status Report for week ending May 30, 2014 Status by Team Workstream #11: Org Change Management Team Accomplishments (prior week) Updated the drafted Deliverable Expectations Document for Organization Change Management (OCM) Strategy Met with the client to discuss Cover Oregon’s communication channels, awareness campaign, and engagement and outreach Identifying topics in which more information is needed in regards to 5503 Began conversations to facilitate a site visit to 5503 Prepared for Cover Oregon and Oregon Health Authority (OHA) staff interviews Upcoming Work (current week) Conduct a site visit to 5503 Meet with Kathleen P. and Judy M. P. to gain a broader understanding of the work done within 5503 Conduct Cover Oregon and OHA staff interviews Consolidate notes from interviews Begin documenting areas of focus for OCM based on developed business processes, identifying manual and newly automated processes Issues/Risks State counterpart will not be on-boarded until June 3 Leads: [client - TBD]/Jennifer M.

17 About Deloitte Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, and its network of member firms, each of which is a legally separate and independent entity. Please see for a detailed description of the legal structure of Deloitte Touche Tohmatsu and its member firms. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.www.deloitte.com/aboutwww.deloitte.com/us/about Copyright © 2014 Deloitte Development LLC. All rights reserved. Member of Deloitte Touche Tohmatsu


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