RD152 - Semi-Annual Progress Report on Eligibility Systems Modernization - July 2013

Executive Summary:
The Department of Social Services (DSS) entered into a contract with Deloitte Consulting, LLP to modernize the existing automated eligibility systems for all public assistance programs, beginning with the Medicaid program. As part of the federal Patient Protection and Affordable Care Act (PPACA), Medicaid customers must be allowed to file applications via mail, phone, web, fax, or in person. DSS has partnered with the Department of Medical Assistance Services (DMAS) to accommodate changes to the technology to support implementation of the new Medicaid requirements and eligibility determination using Modified Adjusted Gross Income (MAGI) rules.

The scope of the contract includes implementation of the changes to Medicaid to meet the PPACA requirements, replacement of the current legacy eligibility system Application Benefit Delivery Automation Project (ADAPT), automating Medicaid categories not currently in ADAPT, implementation of a statewide document management and imaging system, and conversion of current Families Access to Medical Insurance Security and Medicaid cases from ADAPT and the DMAS system, Child Health Administration Management Program System, into the new case management system, Virginia Case Management System.

Work on the eligibility modernization projects has begun, starting with a formal kick off held in December 2012. There are three projects for eligibility modernization: the MAGI project; Program Migration project; and a Conversion project. The MAGI project is the first project scheduled to be delivered. The timeframe for this project is December 2012 through October 2013. The timeframe for the Program Migration Project is February 2013 through December 2015. The timeframe for the Conversion project is March 2013 through March 2014.

The initial report (report mandate in Appendix A) issued in January 2013, included background information on the federal PPACA, described the requirements under the PPACA, and the three eligibility modernization projects. Because the contract with Deloitte Consulting, LLP was executed in December 2012, the initial report consisted mainly of background and preliminary project status information. The focus of this report is to provide the status of the three projects, as well as to document project expenditures to date. Currently, all three projects are active and following their prescribed schedules.

The first of the three projects, the MAGI project, is in the execution and control phase. Business requirements have been captured, design specifications documented and development is well underway. The MAGI project has had one change order, to accommodate interfaces with the legacy Medicaid Management Information System, but is progressing. The MAGI project teams, both business and technical, are currently working through information technology infrastructure and application integration challenges, anticipating successful resolution to meet the October 2013 implementation date.

As part of the oversight provided by the federal Centers for Medicare and Medicaid Services, states must pass a series of technical readiness reviews, called Gate Reviews. Interfacing with the federal components of PPACA is a requirement. Other federally defined test criteria and success measures must be met prior to a formal end-to-end test of functional readiness that will be scheduled for August 2013.

Total expenditures through April 2013 include salaries for the DSS staff and the procurement of hardware/software tools for the MAGI project. These expenditures total $8,355,299. To date, payments of $3,051,848 have been made to Deloitte Consulting, LLP. Over $3,700,000 has been spent on hardware and software products, with the balance of expenditures being for administrative costs such as staff and training.