[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] ----------------------------------------------------------------------- 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