1. 1 Prescription Benefits Management (PBM) Medicare Crossover CLOSEOUT PHASE Human Services Department Mark Pitcock, Bureau Chief Program Information Systems Bureau Liz Shaw, IT Project Manager Information Technology Department

2. 2 Medicare Crossover Project Overview Allows Part B claims to be submitted via two different processes: The Region C Durable Medical Equipment Regional Carrier; or by Point of Sale Medicare Crossover will be treated as a Coordination of Benefits program with Medicare listed as another type of insurance in the client’s eligibility and Third Party Liability (TPL) information from the Medicaid Management Information System Crossover claims are processed more efficiently and accurately Medicare Crossover claims are more clearly identifiable Funded from the computer enhancement fund reauthorized Laws 2007, Chapter 28, Section 7, Subsection 20 Dept. of Health & Human Services; Centers for Medicare & Medicaid Services. Grant # 0805NM5028

3. 3 Medicare Crossover Accomplishments Initiation Phase: Completed by August 2007 Requirements Analysis Document High Level Project Plan Project Management Plan Planning Phase: Completed by September 2007 Detailed Project Work Plan Detailed System Design Document Implementation Phase: Completed by May 2008 System Test Execution User Acceptance Test Execution IV&V Reports Project solution was migrated into MMIS Production on May 5, 2008 Close-out: Planned to be completed by November 2008

4. 4 Medicare Crossover Next Steps PCC approval of project certification for Close-out Phase, November 2008 Submit close-out report to DoIT, December 2008 Submit APD Update to CMS, December 2008

5. 5 Medicare Crossover Lessons Learned Key success factors Existing successful relationship between the development vendor (ACS) and HSd Deep subject matter expertise Frequent communication between ACS and HSD during system development, implementation, and roll-out Key improvements needed Better alignment of Federal approvals with project certification schedule so that steps can be done in parallel rather than in serial