Enrollemt workgroup

HIT Policy Committee Enrollment Workgroup

Monday, June 14, 2010

12:00pm ET

Call to Order

1. Call to Order– Judy Sparrow, Office of the National Coordinator for Health

Information Technology

2. Introduction of Workgroup Members

3. Overview of Workgroup Role & Charge

4. Introduction to Panel Presentations

5. Panel 1: Enrollment in 2014

6. Panel 2: State/Local eHuman Services Efforts

7. Break

8. Panel 3: Internet/Web Services /Consumer Data Platform

9. Workgroup Discussion

10. Public Comment

11. Adjourn

Agenda

Intro of W G Members

1. Call to Order

2. Introduction of Workgroup Members – Aneesh Chopra, Chair

– Sam Karp, Co-Chair





7. Break



10. Public Comment

11. Adjourn

Agenda

HIT Policy & Standards

CommitteesEnrollment Workgroup

Aneesh Chopra, ChairChief Technology Officer, OSTP

Sam Karp, Co-ChairCalifornia Healthcare Foundation

June 14, 2010

Workgroup Members

Members: Ex Officio/Federal:

• Cris Ross SureScripts Sharon Parrott, O/S, HHS

• James Borland Social Security Administration Nancy DeLew, CMS/HHS

• Jessica Shahin U.S. Department of Agriculture Penny Thompson, CMS/HHS

• Stacy Dean Center on Budget & Policy Priorities Henry Chao, CMS/HHS

• Steve Fletcher CIO, Utah Gary Glickman, OMB

• Reed V. Tuckson UnitedHealth Group John Galloway, OMB

• Ronan Rooney Curam David Hale, NIH

• Rob Restuccia Community Catalyst Paul Swanenberg, SSA

• Ruth Kennedy Louisiana Medicaid Department David Hansell, Administration for

• Ray Baxter Kaiser Permanente Children & Families, HHS

• Deborah Bachrach Consultant Julie Rushin, IRS

• Paul Egerman Businessman Farzad Mostashari, ONC

• Gopal Khanna CIO, Minnesota Doug Fridsma, ONC

• Bill Oates CIO, City of Boston Claudia Williams, ONC

• Anne Castro Blue Cross/Blue Shield South Carolina

• Oren Michels Mashery

• Wilfried Schobeiri InTake1

• Bryan Sivak CTO, Washington, DC

• Terri Shaw Children’s Partnership

• Sallie Milam West Virginia, Chief Privacy Officer

• Dave Molchany Deputy County Executive, Fairfax County

Chair: Aneesh Chopra, Federal CTO

Co-Chair: Sam Karp, California Healthcare Foundation

Section 1561 of Affordable Care Act

1561. HIT Enrollment, Standards and Protocols. Not

later than 180 days after the enactment, the Secretary,

in consultation with the HIT Policy and Standards

Committees, shall develop interoperable and secure

standards and protocols that facilitate enrollment in

Federal and State health and human services

programs through methods that include providing

individuals and authorized 3rd parties notification of

eligibility and verification of eligibility.

Draft Work Plan

• May: Initial Scoping

• June 14 – July 16: HIT Policy and Standards

Committee Workgroup: Inventory, candidate standards,

strategy to address gaps

• July 16 – August 27: Standards development, NIEM

process

• Sept 31: Finalize standards recommendations

Draft Workgroup Charge

• Inventory of standards in use, identification of gaps,

recommendations for candidate standards for federal

and state health and human service programs in

following areas:

– Electronic matching across state and Federal data

– Retrieval and submission of electronic documentation for

verification

– Reuse of eligibility information

– Capability for individuals to maintain eligibility information

online

– Notification of eligibility

Potential Deliverables

1. Inventory of standards-based data exchange in use

today to enroll in health and human services

2. Candidate standards for data elements and

messaging

3. Proposed process to fill in gaps to rapidly turn

"requirements" into working prototypes/live

implementations to deliver world class eligibility and

enrollment services

Potential Candidate Standards

• Core data elements • Name, address, residence, income, citizenship, etc.

• Messaging • Checking eligibility and enrollment

• Consumer matching across systems

• Retrieving and sending “packages” of verification information including income, employment, citizenship

• Communicating enrollment information

• Privacy and security • Secure transport

• Authentication

Standards Requirements

We need to conceptualize standards that might be useful

and work across a variety of use cases or architectures

which might include:

• Front end user-facing consumer portal to conduct initial

eligibility checks and obtain and forward verification

information

• Comprehensive eligibility system for Health and Human

Services programs

• State or Federal exchange portals

Draft Policy Principles

Do not make policy through standards

Standards and technologies must support and be in service to our policy goals:

• Consumer at the center

• Make enrollment process less burdensome; simplify eligibility process and make it seamless

• Enter/obtain information once, reuse for other purposes

• Make it easier for consumers to move between programs

• Focus on 2014 world

Draft Standards Principles

• Keep it simple - Think big, but start small. Recommend standards as minimal as required to support necessary policy objective/business need, and then build as you go.

– Don’t rip and replace existing interfaces that are working (e.g., with SSA etc.).

– Advance adoption of common standards where proven through use (e.g., 270/271).

• Don’t let “perfect” be the enemy of “good enough” Go for the 80 percent that everyone can agree on.

– Opportunity to standardize the core, shared data elements across programs.

– Cannot represent every desired data element.

• Keep the implementation cost as low as possible – May be possible to designate a basic set of services and interfaces that can be

built once and used by or incorporated by states.

– Opportunity to accelerate move to web services.

• Do not try to create a one-size-fits-all standard that add burden or complexity to the simple use cases

– Opportunity to describe data elements and messaging standards that would be needed regardless of the architecture or precise business rules selected.

Overview of W G Role & Charge

1. Call to Order


3. Overview of Workgroup Role & Charge – Aneesh Chopra, Chair

– Sam Karp, Co-Chair




7. Break



10. Public Comment

11. Adjourn

Agenda

Intro to Panel Presentations

1. Call to Order



4. Introduction to Panel Presentations– Aneesh Chopra, Chair



7. Break



10. Public Comment

11. Adjourn

Agenda

Penny Thompson - Panel 1

1. Call to Order




5. Panel 1: Enrollment in 2014– Penny R. Thompson, Centers for Medicare & Medicaid

Services


7. Break



10. Public Comment

11. Adjourn

Agenda

Alice W eiss - Panel 1

1. Call to Order




5. Panel 1: Enrollment in 2014– Alice Weiss, National Academy for State Health Policy


7. Break



10. Public Comment

11. Adjourn

Agenda

Discuss Panel 1

1. Call to Order




5. Panel 1: Enrollment in 2014– Discussion


7. Break



10. Public Comment

11. Adjourn

Agenda

Steve Fletcher - Panel 2

1. Call to Order





6. Panel 2: State/Local eHuman Services

Efforts– Steve Fletcher, Chief Information Officer, Utah

7. Break



10. Public Comment

11. Adjourn

Agenda

State eHuman Services Efforts

HIT Policy CommitteeJune 14, 2010

J. Stephen FletcherChief Information Officer

Utah Health Information Network• UHIN is a State not-for-profit company

• UHIN is a broad-based coalition of nearly all the hospitals, ambulatory surgery centers, national laboratories, insurers, and approximately 90% of the medical providers in Utah as well as the Utah State government.

• All parties exchange data in a standard format using standard codes

– Administrative costs savings

– Opens the door to improving patient care and safety

Utah Health Info

Clinical Health Information Exchange (cHIE)

• Statewide system makes more complete patient information securely available to authorized providers

• Gives providers the capacity to render more informed care and patients have more control over their information

• Provides the means to locate and view information available from the health care entities that participate in this community effort

cHIE

Clinical Health Information Exchange (cHIE)

• 11 entities are exchanging data

• 9 Sites are actively pursuing a connection

• 13 Organizations are collaborating with UHIN

• 12 Electronic medical records vendors are pursuing a connection with the exchange

cHIE cont’d

Potential Issues with HIE• Assumes that since these are government programs,

there is no option for the provider (clinicians and facilities) to opt-out of participating in the HIE and no option for the patient to decide to opt-out of their information being involved in the HIE

• Accurate, unambiguous, non-duplicative provider identification system provided by HIE

– Liability protection

– Lack resources

– Primary identity focus is on keeping the patient identities unique and unambiguous, not the provider

Potential Issues w/HIE

State of Utah eREP: Front End Eligibility Check

• eREP has a Rules Engine that cascades all information entered and suggests the optimal program according to eligibility rules

• Data linking is done through web services links– Link to common shared customer information across

several state applications– Use common standards for linking to certain Federal data

sources such as Social Security, PARIS match, IRS, National New Hire

– Mostly use Mainframe standards, use web services where available

– Currently in the process of changing financial transactions to web services

Utah state eREP

State of Utah eREP: Front End Eligibility Check (continued)

• Programs Included

– CHIP and various related programs for adults

– All Medicaid and cost sharing programs including several optional and waiver programs

– TANF/FEP and Refugee financial programs

– Several State optional financial programs

– Food stamps

– Child care assistance

Utah State eREP cont’d

State of Utah eREP: Multiple Program Eligibility

• Interfaces used to obtain electronic verification information:

– All available Federal and State electronic match data, including the complete array of Social Security information such as BENDEX, SDX, Wire Third Party, SOLQ, SVES, Prison Match, Death Match.

– IRS data including BEERS and the 1099 information provided on matching clients.

– State/Federal consortiums such as PARIS match for civil service and veterans benefits, as well as the National New Hire Registry for TANF/FEP.

eREP Multiple Program Eligibility

State of Utah eREP: Multiple Program Eligibility (continued)

• Standards Used – Mainframe file transfer protocols established by the

Federal partner (NDM transactions)

• Data Elements for Consumer Entry– On-line application which creates an imaged document real

time– State worker manually inputs the information from the

imaged application into eREP

• Consumer Authentication– Consumer verifies through electronic signature– Consumer then participates in immediate interview with no

appointment necessary

Multiple Program Eligibility cont’d

State of Utah eREP: Sending Packets

• Business Rules are maintained at the program level

– All business rules are applied centrally at the application level, allowing the cascading process to select any and all appropriate programs

• Standards used for messaging are IBM Websphere MQ and JMS

eREP Sending Packets

Bobbie W ilbur - Panel 2

1. Call to Order






Efforts– Bobbie Wilbur, Social Interest Solutions

7. Break



10. Public Comment

11. Adjourn

Agenda

Social Interest Solutions

Testimony

HIT Policy Committee

Enrollment Workgroup Meeting

Washington, DC

June 14, 2010

©2010 SIS Confidential and Proprietary

Social Interest Solutions

• Independent, mission-driven non-profit organization

• Systems development, implementation, maintenance and

enhancement

• Integrated eligibility and case management systems and other

solutions to support consumers

• Support a range of state, county and city jurisdictions

• Handle a range of public and private programs

• One-e-App is the SIS signature product for eligibility and

enrollment in programs


The One-e-App Approach

• Web-based system

• Consumer-centric channels via:

– Self-service

– Call center

– Assisted application support

• Offers a secure single point of entry

• Provides simultaneous preliminary and/or final eligibility

determination across multiple public and private programs


More on the approach . . .

• Verifies applicant information via automated verification, scan,

fax and e-mail and stores and manages verifications for

submission to other systems and for future re-use

• Supports telephonic and a variety of electronic signatures

• Provides a consumer “home page” to allow for self-management

of new applications, change in circumstances (modify), renewals

(re-certification) for all programs

• Provides consumer (and assistors) communication and

notification via e-mail, text messaging and paper

• Integrated across a range of public and private systems


What Makes One-e-App Work

• Careful, deliberate and complete gathering of consumer

information

• Real-time information verification through system and process

integration

• Searching enrollment systems for existing or prior benefit

coverages

• Real-time eligibility determination or routing

• Augmenting the capabilities of existing legacy systems

• Configurable client administration

• Never accepting “it can’t be done”


Standards and Integration

• Innovative system integration using a range of tools from “mash

ups” to complex web services

• Translators that provide for data exchange across a continuum

from HL7 to X12 to XML to . . .

• Utilizing existing standards including:

– ADA

– HIPAA (Privacy and Trading Data (Transactional)

– MITA

– US Postal Standards

• Augmenting the capabilities of existing legacy systems


Consumer Access

Consumer Access

• Match Birth Record

• Apply, Modify, Renew Applications

• Submit Applications Electronically

• Submit Verification Documents

Electronically

• Select Medical Home or Provider

• Look Up Eligibility Status

• Manage Outreach, Notifications, Case

• Access Data Mart

• Other Features

ConsumerSelf-Assistance

Certified Community

Assistor

ProviderAssistor

Call CenterAssistor

Mail-In Paper Application

County Assistor

Outreach Provider Assistor


One-3-App Architecture

The One-e-App Architecture

Verification

Systems

Web

Service

State & County

Eligibility

Systems

Web

Service

USPS

Web

Service

Other Systems:

Kaiser, Utility, School,

City, Health Plan, . . .

Web

Service

Patient

Management

Systems

Web

Service

Clearinghouse

Systems

Web

Service

State

Medicaid

Systems

Web

Service

Authentication

Services

Workflow

Engine

Data Transformation

Services

Dispatcher

Services

System Integration

Engine

Data Validation

Service

Document

Management Service

Other Services

Information

Verification Service

Business

Intelligence

Enterprise Integration Portal

Enterprise Service Bus

. . . MITA architecture with services that can be

leveraged to augment legacy systems


Enrollment Across Programs

• Health Programs:

– Medicaid

– SCHIP

– EPSDT

– Medicare Cost Sharing

– County Indigent Care Programs

– County, Clinic and Hospital Sliding Fee Programs

– Hospital Charity Care Programs

– County Expansion or Access Programs

– Kaiser Permanente Child Health Plan and Kaiser Bridge

– CaliforniaKids

– Express Lane Eligibility (school lunch / MC linkage)

– Pharmacy Discount Programs


More Programs . . .

• Food Stamps (SNAP)

• TANF (Temporary Aid to Needy

Families)

• Supplemental Nutrition for

Women, Infants and Children

(WIC)

• Earned Income Tax Credit

(EITC)

• Child Tax Credit

• Voter Registration

• Low Income Energy Programs

• Low Income Auto Insurance

• Employment Assistance (WIA)

(Coming Soon)

• Family Planning

• Cancer Detection and Treatment Programs

• General Assistance

• Drug and Alcohol Rehab Program

• Homeless Assistance

• Others


Reach

• Arizona: Health-e-Arizona

• Indiana: Ind-e-App

• Maryland: Health-e-Link and Healthy Maryland (Coming Soon!)

• California:

– One-e-App

• 15 California Counties

• City of Los Angeles

• Los Angeles Unified School District

– Health-e-App – Statewide

• Kaiser Permanente Child Health Plan

• PG&E CARE Program

• CaliforniaKids

• Pharmaceutical Patient Assistance Programs (Coming Soon)


ACA Player Summary

ACA Player Summary

Federal Portal

•Information

•Routed to State Portal

State Portal

•Information

•Routed to Eligibility and Enrollment Systems

•Coverage Updates

•Consumer Portal

Medicaid

•Information

•Application Support in Medicaid System

•Exchange with Verification Systems

•Referral to Other Programs

•Coverage to Other Players

•Coverage Management

•Cost of Coverage

Social Services

•Information

•Application Support in Social Service System




•Coverage ManagementState Exchange

•Information

•Application Support for Private Insurance

•Determine If Medicaid Prior to Private Insurance




•Coverage from Medicaid and State High Risk

•Billing and Collecting Employee



•Cost of Coverage

Insurance Companies on the State Exchange

•Information

•Consumer Coverage Confirmation

•Track Changes in Consumer CoverageState High Risk Insurance

•Information

•Determine Medicaid Prior to High Risk Insurance

•Application Support for High Risk Insurance





IRS

•Records Match

•Report No Coverage Consumer

•Long term, should incorporate the ability to apply through tax return

•Assess penalty to non-covered


ACA Players Must

Employ Electronic Matching to serve as evidence of eligibility in lieu of paper☐ Vital Records☐ Employment history☐ Enrollment system☐ Tax records☐ Other

Simplify verification and submission of documents☐ Digitization of documents☐ System verification

Reuse of stored eligibility information to assist with retention of eligible individuals

Provide Online access for individuals to:☐ Apply☐ Recertify☐ Manage eligibility information

Expand enrollment systems to:☐ Integrate new programs☐ Integrate new rules☐ Integrate new functionalities☐ Operate at increased volumes☐ Apply the streamlined eligibility and verification processes to other Federal and State programs

Notify parties of eligibility, recertification and other needed communication by:☐ Email☐ Cell Phone (e.g., text messaging, Apps)☐ Other

Provide other functionalities to streamline the enrollment process

ACA Players Must


ACA Player Summary

Federal Portal

•Information

•Routed to State Portal

State Portal

•Information

•Routed to Eligibility and Enrollment Systems

•Coverage Updates

•Consumer Portal

Medicaid

•Information

•Application Support in Medicaid System





•Cost of Coverage

Social Services

•Information

•Application Support in Social Service System




•Coverage ManagementState Exchange

•Information

•Application Support for Private Insurance

•Determine If Medicaid Prior to Private Insurance




•Coverage from Medicaid and State High Risk

•Billing and Collecting Employee



•Cost of Coverage

Insurance Companies on the State Exchange

•Information

•Consumer Coverage Confirmation

•Track Changes in Consumer CoverageState High Risk Insurance

•Information

•Determine Medicaid Prior to High Risk Insurance

•Application Support for High Risk Insurance





IRS

•Records Match

•Report No Coverage Consumer

•Long term, should incorporate the ability to apply through tax return

•Assess penalty to non-covered

Patient Management and EHR

County and Community Safety Net ProgramsHealth Plans ACA Player Summary


Leverage, Leverage…

Adopt ExistingStandards with MinimalModifications

Augment Legacy Systems

Build on MITA Standard Architecture for High Re-use

Real-Time Verifications & Eligibility Determinations

Leverage Medicaid to Support Underpinnings for Insurance Exchange and Other Programs

Allow for new external

programs and services via

ESB

Consumer-

Centric ACA

Results!


Contact

Bobbie Wilbur

Co-Director

916-566-2643

[email protected]

Claudia Page

Co-Director

510-273-4641

[email protected]

www.socialinterest.org

mailto:[email protected]

mailto:[email protected]

http://www.socialinterest.org

Ruth Kennedy - Panel 2

1. Call to Order






Efforts– Ruth Kennedy, Louisiana Medicaid

7. Break



10. Public Comment

11. Adjourn

Agenda

Electronic EligibilityProcesses in Louisiana

A State PerspectiveLouisiana Medicaid & CHIP

Eligibility Division

HIT Eligibility Workgroup MeetingJune 14, 2010

J. Ruth KennedyLa. Dept of Health & Hospitals

http://go2.wordpress.com/?id=725X1342&site=nyshei.wordpress.com&url=http%3A%2F%2Fnyshei.files.wordpress.com%2F2007%2F05%2Finfo_ethics1.jpg&sref=http%3A%2F%2Fnyshei.wordpress.com%2F2007%2F05%2F23%2Fwhos-using-information-technology%2F

The Case for EligibilityAutomation in Louisiana

Genuine desire to reduce number of uninsured, increase enrollment & access

Accelerate (faster) enrollment and maximization of retention

Advances in technology presented new opportunities

Severe state budget shortfalls

Eligibility workloads spiraling out of control

We believed it was possible to do so without compromising program integrity

Starting Assumptions

Important differences in eligibility for public health coverage and TANF/SNAP

Less need for income preciseness

Underlying philosophy and goals

Automated processes will increase enrollment and retention of eligible individuals

Integrating IT into eligibility business processes is a heavy lift— about more than standards!

Electronic Case Records (ECR)= Transformative

Totally paperless, web-based eligibility case records

Includes images of all incoming and outgoing documents

All eligibility employees in state can create, add to and access the ECR

Now institutionalized—conversion was completed in July, 2005

Why Convert to Electronic Eligibility Case Records?

Major savings

Labor and rental costs

Postage, filing systems, paper, printing costs, toner

Immediate accessibility to documents and data

better customer service

makes paperless eligibility business processes practical

Trolley

Files

Ex Parte Renewals Using SNAP Data Since 2001

High level of confidence in SNAP income data

Match with DSS system identifies & flags children due for renewal with active SNAP case

Caseworkers still play major role in decision making

Income in SNAP system for Medicaid/CHIP income unit members is cross walked

~ 2/3 of Medicaid children in active SNAP case

Has resulted in dramatic reduction in procedural (paperwork) closures

Can We Built a Better Mousetrap?

Federal regs (42CFR 435.9160) mandate periodic redetermination ―at least every 12 months‖

In the 21st Century, is there a better way to do so for low risk cases?

Intensive data mining to determine case characteristics

Extensive testing and refining prior to implementation

http://images.google.com/imgres?imgurl=http://thediscoblog.com/images/mouse-trap.jpg&imgrefurl=http://thediscoblog.com/2008/05/29/the-business-model-or-lack-thereof-of-selling-unit-testing/&usg=__LjuF038gwEaMzGeqazn2wC8xe0k=&h=303&w=282&sz=34&hl=en&start=54&tbnid=1D9OJPKDncH0WM:&tbnh=116&tbnw=108&prev=/images?q=better++mousetrap&gbv=2&ndsp=18&hl=en&sa=N&start=36

Web-Based Applications

We believe electronic signature is critically important

Focus groups indicate families appreciate the option

Eliminates the need for scanning; data electronically goes to ECR

Continuous improvement in functionality

4 photos LaChip

Express Lane Eligibility(ELE)

CHIPRA option to use eligibility decisions by other agencies

Electronic eligibility data from SNAP agency

Over 14,000 children < age 19 have been automatically enrolled

Some Lessons From the ELE Bleeding Edge

Simplification isn’t simple!

Data matching isn’t ―magic‖ or totally clean

―Automatic‖ is relative

Human intervention is still important

Beware the Watchman!!

―The government are very keen on amassing statistics. They collect them, add them, raise them to the Nth power, take the cube root and prepare wonderful diagrams.

But you must never forget that every one of these figures comes in the first instance from the village watchman, who just puts down what he . . . pleases.”

--Sir Josiah Stamp, 1880-1944Head, Bank of England

Yikes!!

―Organizational Change‖ is Essential to Maximize IT

Even more important than technology

Caseworkers ―open‖ and ―close‖ the door

Requires fundamental change in approach to eligibility

Major changes in expectations of caseworkers and managers

It’s about winning hearts & minds

Louisiana’s Eligibility HIT Wish List for HHS

Enhanced FFP for ―standalone‖ Medicaid/CHIP eligibility systems

Data standards

Reporting requirements

Dissemination of information about state HIT eligibility innovations and ―lessons learned‖

ELE-type eligibility processes for adults as well as children

Ruth KennedyLaCHIP Director & Medicaid Deputy DirectorLouisiana Department of Health & HospitalsP.O. Box 91030 Baton Rouge, LA 70821-9030Telephone: 225 342 3032Blackberry: 225 241 1437Fax: 225 342 9508E-Mail: [email protected]

www.lachip.org

Never doubt that a small group of thoughtful, caring people can change the world Indeed, it is the only thing that ever has !— Dr. Margaret Mead

http://www.lachip.org/

Discuss Panel 2

1. Call to Order






Efforts– Discussion

7. Break



10. Public Comment

11. Adjourn

Agenda

W es Rishel - Panel 3

1. Call to Order






7. Break

8. Panel 3: Internet/Web Services /Consumer

Data Platform– Wes Rishel, Gartner


10. Public Comment

11. Adjourn

Agenda

This presentation, including any supporting materials, is owned by Gartner, Inc. and/or its affiliates and is for the sole use of the intended Gartner audience or other authorized recipients. This presentation may contain information that is confidential, proprietary or otherwise legally protected, and it may not be further copied, distributed or publicly displayed without the express written permission of Gartner, Inc. or its affiliates.© 2010 Gartner, Inc. and/or its affiliates. All rights reserved.

Wes Rishel

Distinguished Analyst

14 June 2010

Washington DC (via telephone)

Enrollment Working Group Testimony

Why is interoperability so darn hard?

An Interoperability Joke:

Mrs. Johnson brings little Johnny in for his first day of school.

After meeting the teacher in a group of moms, she pulls the teacher aside and says:

Johnny is very sensitive, So, if he misbehaves,

don’t hit him.

Hit the kid next to him.

That will scare him and he will straighten up.

Things To Consider Standardizing

• Core data elements

• Name, address, residence, income, citizenship, etc.

• Codes and structure (e.g., citizenship and ethnicity)

• Signature: Electronic and/or digital; applicant, third-party data source

• Data Formats

• Business Functions

• Checking eligibility and enrollment

• Consumer matching across systems

• Retrieving and sending “packages” of verification information including income, employment, citizenship

• Communicating enrollment information

• Privacy and security

• Auditing and other provisions for detecting, investigating and proving fraud

• Secure transport

• Authentication

• Identity vetting

• Package integrity

Impedance Matching:The Interoperability Metaphor

• The maximum high-fidelity data transfer occurs when the representation of data and the process are the same in both systems/organizations

• The maximum interoperability is probably << half the total understanding of semantics and process at either end

Source Computer orOrganization

Receiving Computer orOrganization

OlderSystem

Highly "Informatical"

Systems

1001 0100 0100

1011 1110 0101

1001 0100 0100

1011 1110 0101

Incremental Interoperability:Variable Impedance Matching

1001 0100 0100

1011 1110 0101

1001 0100 0100

1011 1110 0101

*

*More Structure or Less;Not All or None

*

Preventing FIS:Frozen Interface Syndrome

• Make incremental interoperability a fundamental business premise

- Variable structure

- Require mappable code upgrades

- Flexible utterances

• Use business incentives to drive upgrades to system informaticallevels

• Make interface negotiation a part of the infrastructure

Vision: Putting the Consumer in ChargeControl v. Transparency; Source Authenticity

Source’s Seal of Authenticity

Trusted Data Bank

Consumer Account

Data Set

Data Set

Data Set

Policies and Compliance RulesConsumer

• Creates and signs data sets

• Edits self-signed data sets

• Establishes identity relationships with other data sources

• Authorizes one-time and ongoing transfers

• View all data sets (with few limitations)

• Deletes self-signed and selected other data sets

• Creates externally attached comments on other-sourced data sets

• Authorizes services of 3rd party advocates

Data User

• Establishes identity relationship with consumer

• Retrieves authorized data

• Edits self-signed data sets

• Validates seals of authenticity

• Provides history and status updates as signed data sets

• Maintains valid seal of authenticity (for verifying authorization and audit logs)

3rd Party Data Source

• Establishes identity relationships consumer

• Provides signed authorized data

• Maintains valid seal of authenticity

Trusted Data Bank

• Provides APIs and user interface for stakeholders

• Continually meets compliance requirements for security and privacy

• Provides forensic-quality logs

• Warrants to hand off data to other trusted data banks

Invention Quote

Invention, it must be humbly admitted, does not consist in creating out of void, but out of chaos.

Julie Rushin - Panel 3

1. Call to Order






7. Break


Data Platform– Julie A. Rushin, Deputy CIO, IRS


10. Public Comment

11. Adjourn

Agenda

IRS - FAFSA

Internal Revenue Service (IRS)

Free Application For Federal Student Aid (FAFSA)

June 14, 2010

Federal Student Aid (FSA) mandated through the American Recovery and Reinvestment Act to simplify the Free Application for Federal Student Aid (FAFSA) process

IRS and FSA data exchange discussions begin (December 2007)

Decision made to allow students and parents access to IRS tax data needed to complete the FAFSA (March 2009)

The IRS solution, the Federal Student Aid-Datashare (FSA-D) application, successfully deployed January 28, 2010.

Project Overview- Background

FSA-D Interface with Dept. Of Ed.

FSA-D is accessible from within the FAFSA

application process only.

FSA-D has no direct interface with the Department of

Education.

FSA-D has external interfaces to taxpayer (and 3rd

party) web browsers and IRS programs.

Data is transferred to and from the Department of

Education through an 128 bit SSL encrypted HTTP

Post via the taxpayer’s browser.

Modernized Production Systems and Services

FSA-D interacts with production programming

to retrieve information from the Individual

Return Transaction File (IRTF).

FSA-D logs messages to the Security Audit

and Analysis System (SAAS) which

implements a data warehousing solution to

provide on-line analytical processing of audit

trail data.

Department of Ed Process

ED Applicant (Student or Parent) initiates the on-line process for Free Application For Student Aid (FAFSA) Includes application for a PIN (if not previously secured)

User provides SSN, Name, DOB, Address and selects a challenge question to activate the PIN

User information validated through Social Security Administration (SSA)

User- or ED-created PIN provided to user instantly, via email or through postal service

PIN considered conditional until validated by SSA and can only be used to sign the FAFSA (SSA validation completed within one to three days)

Applicant completes the applicable FAFSA On The Web (FOTW) Input Screens User’s SSN, DOB, Name and PIN collected

Link to IRS FSA-D is displayed

IRS FSA-D Input Screen

IRS FSA-D Data Elements to User

User Returns to on-line FAFSA

Current Statistics

Statistics from 1/28/2010 through 6/10/2010

612,279 users requested access

324,018 users successfully authenticated (52.9 % of volume)

303,118 users transferred tax information to FAFSA (49.5% of volume)

Planned Enhancements

*Changes to the FAFSA question numbers Change the design to display the FAFSA form question numbers that

correspond to the version of the form being completed by the applicant.

*Return Correlation ID of all FSA-D Users Improves the user experience by enabling ED to return users exiting

the FSA-D to the appropriate section of the FAFSA.

*Spanish language version Mirror the features and functionality of the English language FSA-D.

Non-editable date of birth field Enhance the Security and Privacy of the FSA-D application by

changing the Date of Birth field on the Authentication Page from an editable to a non-editable field (Requested by Privacy)

*Denotes Department of Education (ED) request.

Questions and Comments

Paul Swanenburg - Panel 3

1. Call to Order






7. Break


Data Platform– Paul Swanenburg, Social Security Administration


10. Public Comment

11. Adjourn

Agenda

CHIPRA Citizenship Match

CHIPRA Citizenship MatchWith SSA (SCHIP)

StateMEDICAID & CHIP Agencies within

Existing-Approved Network

SSAProvides Name, SSN, DOB and

Citizenship Matching

StateMEDICAID or CHIP Agencies outside

Approved Network

MEDICAID & CHIP Agency

2

3

4

1

2

1

Diagram 1

SCHIP

•Provides name, SSN, DOB andcitizenship matching

•Uses an existing and approved telecommunications network in place between SSA and all states-File Transfer Management System (FTMS)

•Uses an existing batch query in place with all states – State Verifications and Exchange System (SVES)

•Part of existing data exchange agreement between STATES and SSA (CMPPA & IEA) for MEDICAID and CHIP

Affordable Care Act – 90 Day Requirement

Affordable Care ActCitizenship Match with SSA

90 Day Requirement (SCHIP)

Diagram 2

SCHIP (90 Day)

•To meet 90 day (06/21/10) requirement-use CHIPRA SCHIP Query

•Use existing FTMS & SVES Network/Query

•Modify existing information exchange agreements (IEA) with States

•Opt out States using HHS contractor and States requiring new Computer Matching and Privacy Protection Act (CMPPA) agreements would not meet 90 day criteria

State•Opting In

•HRP within Umbrella of

DHS/STC

State•Opting Out

•Opting In but HRP outside of DHS/STC

1

2



Affordable Care Act - HRP

Affordable Care ActCitizenship Match with SSA

States Administering Own High Risk Pool (HRP)

Diagram 3

SCHIP (06/21/10 – 12/31/13)

•Use CHIPRA SCHIP Query

•Use existing FTMS & SVES Network/Query

•Modify existing information exchange agreements (IEA) with States within umbrella of DHS/STC

•Create new agreements/security approvals for HRPs outside of existing/approved DHS/STC umbrella

State•Opting In

•HRP within Umbrella of

DHS/STC

State•Opting In

•HRP outside of DHS/STC

1

2



HRP

2 3

1

4

Affordable Care Act – State Fallback

Affordable Care ActCitizenship Match with SSAStates Opting Out-Fallback

Diagram 4

(NFC)

Administering Opt Out States HRPs

1

2SSA

Provides Name, SSN, DOB and


SCHIP (06/21/10 – 12/31/13)

•Use CHIPRA SCHIP Query

•Operate within approved FTMS network using SVES based query

•Create new CMPPA/IEA agreements

ASSUMPTIONS:1. Queries will not be routed

through PA DPW2. NFC approved site will administer

all opt out states3. FTMS approved network technology

will be used4. Administered through 12/31/13

Multiple SourcesInput for

Enrollment Process

3

Bryan Sivak - Panel 3

1. Call to Order






7. Break


Data Platform– Bryan Sivak, CIO, Government of D.C.


10. Public Comment

11. Adjourn

Agenda

Discuss Panel 3

1. Call to Order






7. Break


Data Platform– Discussion


10. Public Comment

11. Adjourn

Agenda

W G Discussion

1. Call to Order






7. Break


9. Workgroup Discussion10. Public Comment

11. Adjourn

Agenda

Adjourn

Meeting Adjourned

Enrollemt workgroup

Technology

standards standards

secure standards

standards recommendations

standards committee

standards development

standards requirementswe

draft standards principles

workgroup members chair