[Federal Register Volume 61, Number 25 (Tuesday, February 6, 1996)]
[Notices]
[Pages 4443-4444]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-2373]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Bureau of Program Operations, Statement of Organization,
Functions, and Delegations of Authority
Part F of the Statement of Organization, Functions, and Delegations
of Authority for the Department of Health and Human Services, Health
Care Financing Administration (HCFA), (60 FR 42888, 42889, 42898, and
42899, Aug. 17, 1995) is amended to reflect a reorganization in the
Bureau of Program Operations (BPO).
BPO is moving the Medicare Transaction System (MTS) functions from
the MTS Initiative Task Force to the Office of Analysis and Systems
(OAS). Expanding OAS's functions to include MTS is necessary because
HCFA is transitioning to a new phase in the development of MTS. This
phase requires a different management strategy to align the initial
planning decisions with the organizational component that will bear
responsibility for implementing MTS and ultimately strengthen the
overall management of MTS.
The specific amendments to part F are described below:
Section F.10.D., Health Care Financing Administration, Associate
Administrator for Operations and Resource Management (FL)
(Organization), paragraph 4.b. is amended by adding subparagraphs (5)
through (7). Paragraph 4.g. and all the associated subparagraphs are
deleted in their entirety.
b. Office of Analysis and Systems (FLG1)
(5) Medicare Transaction System Quality Assurance (FLG15)
(6) Medicare Transaction System Development (FLG16)
(7) Medicare Transaction System Program Planning & Needs Analysis
(FLG17)
Section F.20.D, Health Care Financing Administration Associate
Administrator for Operations and Resource Management (FL) (Functions),
paragraph 4.b. is deleted and replaced with the following new
functional statement. In addition, paragraph 4.b. is further amended by
adding subparagraphs (5) through (7). Paragraph 4.g. and subparagraphs
(1) through (3) are deleted in their entirety.
b. Office of Analysis and Systems (FLG1)
Provides requirements and specifications for the design,
development, and maintenance of reporting and information management
systems that generate data reflecting on Medicare program operations.
Serves as the Agency focal point for the management and
coordination of the Medicare Transaction System Initiative (MTSI).
Represents HCFA to the Department, other Federal Agencies, and outside
organizations.
Provides direction and technical guidance for the design,
development, implementation, verification and validation, and
maintenance of the Medicare Transaction System (MTS) to integrate
Medicare Part A and Part B claims processing systems.
Identifies reporting and information needs for data
relating to Medicare contractor operations and initiates appropriate
action for establishing or modifying the reporting and information
systems to satisfy these needs.
Analyzes a broad range of information, including computer
stored data, on operations performed in support of the Medicare
program; prepares interpretive reports and recommendations on findings
to internal bureau components for purposes of conducting program and
performance evaluations.
Provides overall support to other staff in analyzing and
interpreting program and operational data to better understand the
program.
Provides requirements and specifications for the design,
development, and management at the national level, activities required
to enhance systems for improvement of the Medicare eligibility systems,
Part A and Part B claims processing systems, and the Medicare program
database.
Provides direction and guidance to HCFA staff (central
office and regional) on improving contractor systems.
Prepares systems plans and develops policies for the
design, implementation, and evaluation of shared systems and
standardized modules for use by Medicare carriers, intermediaries, and
hosts.
Directs the design, development testing, and
implementation of innovative system enhancements to the Common Working
File (CWF) shared claims processing systems resulting in improvements
to the national Medicare claims payment process.
Provides requirements and specifications for the
development, implementation, execution, and monitoring of a procedure
to provide ongoing testing of national claims processing and
information system to detect flaws in the operation of software,
hardware, and related operations.
Provides requirements and specifications for the
development and implementation of systems that provide for the creation
and maintenance of databases and test files that are required to
conduct comprehensive system acceptance testing of a national claims
processing and information system.
(5) Medicare Transaction System Quality Assurance (FLG15)
Develops, implements, directs, and operates activities to
assure the quality of Medicare Transaction System (MTS) development
throughout the system development life cycle.
Provides technical management, oversight, coordination and
day-to-day monitoring of contract(s) for the independent verification
and validation of MTS analysis, design, development, validation,
implementation, and maintenance activities.
Reviews and evaluates the effectiveness of the processes
and procedures used to analyze, design, develop, implement, and
maintain the MTS.
Provides the documentation and analysis necessary to
initiate and support corrective action resulting from findings of the
MTS quality assurance activities.
Reviews and evaluates quality assurance programs
maintained by the MTS design contractor, the independent verification
and validation contractor and HCFA to ensure integration of quality
assurance activities throughout the MTS development process.
Recommends alternatives to proposed methodologies for the
analysis, design, development, validation, implementation and
maintenance of the MTS.
(6) Medicare Transaction System Development (FLG16)
Develops, implements, and directs activities to assure the
development of the Medicare Transaction System (MTS) throughout the
system development life cycle.
Provides technical management, oversight and coordination
and day-to-day monitoring of the contract(s) for performing the
Medicare Transaction System (MTS) analysis, design, development,
validation, implementation, and maintenance activities.
Provides the inter- and intra-component coordination
required to insure appropriate and timely review
[[Page 4444]]
and dissemination of the contract work products and other pertinent
information.
Reviews and evaluates the effectiveness of the processes
and procedures used to coordinate and facilitate the review of the
contract work products.
Develops, conducts, and coordinates modifications to
existing operational procedures, contracts, reporting mechanisms and
related materials as required.
Provides the documentation and analysis necessary to
initiate and support corrective action resulting from the findings of
the MTS development activities.
(7) Medicare Transaction System Program Planning and Needs Analysis
(FLG17)
Recommends alternatives to existing requirements,
operational priorities, processes, procedures, and methods for
improvement which will enhance the quality and cost-effectiveness of
Medicare operational and administrative procedures and meet the needs
of HCFA's internal and external customers.
Develops, implements, and directs project planning,
control and administration procedures, processes, and methods used to
determine Medicare Transaction System Initiative (MTSI) program status,
assess performance, report progress, and implement changes.
Maintains the MTSI program schedule and MTSI program
management plan and various program management databases.
Provides advisory and consultative services on project
planning to HCFA central and regional office staff and key officials
responsible for planning and implementing projects in support of the
development and implementation of the Medicare Transaction System.
Conducts project planning training to HCFA staff
responsible for MTSI projects.
Dated: December 21, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 96-2373 Filed 2-5-96; 8:45 am]
BILLING CODE 4120-01-P
