Proposal to Meet Program Requirements. This section of the application will provide CCIIO with a high level overview of the State’s strategic plan to establish an Exchange, participate in the Federally-facilitated Exchange, or collaborate with the Federally-facilitated Exchange in a State Partnership model on certain activities. Regardless of the Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effort. In the proposal to meet program requirements, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be in alignment with the work plan, budget, and budget narrative. Please complete the proposal to meet program requirements based on the Exchange model for which the State is applying. Discuss the State’s current Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness to complete the applicable Exchange Activities. Discuss the State’s strategy to complete the Exchange Activities. Discuss any activities that the State must execute in order for a fully functional Exchange to operate in the State. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. Describe the proposed solution for Exchange IT Systems. Will this be an independent application, an enhancement to existing functionality, or some other solution option? Outline how tightly coupled the proposed Exchange systems will be with existing Medicaid/CHIP systems. Discuss the Exchange’s strategy to interface with all necessary IT Systems, including any information systems used to regulate health insurance within the State and Medicaid/CHIP systems. IT Seven Standards and Conditions: Where applicable, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss, in a separate section, the approach to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs.
Appears in 1 contract
Samples: Cooperative Agreement
Proposal to Meet Program Requirements. This section of the application will provide CCIIO with a high level overview of the State’s strategic plan to establish an Exchange, participate in the Federally-facilitated Exchange, or collaborate with the Federally-facilitated Exchange in a State Partnership model on certain activities. Regardless of the Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effort. In the proposal to meet program requirements, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be in alignment with the work plan, budget, and budget narrative. Please complete the proposal to meet program requirements based on the Exchange model for which the State is applying. • Discuss the State’s current Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness to complete the applicable Exchange Activities. • Discuss the State’s strategy to complete the Exchange Activities. Discuss any activities that the State must execute in order for a fully functional Exchange to operate in the State. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. • Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. • Describe the proposed solution for Exchange IT Systems. Will this be an independent application, an enhancement to existing functionality, or some other solution option? Outline how tightly coupled the proposed Exchange systems will be with existing Medicaid/CHIP systems. Discuss the Exchange’s strategy to interface with all necessary IT Systems, including any information systems used to regulate health insurance within the State and Medicaid/CHIP systems. • IT Seven Standards and Conditions: Where applicable, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df • Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. • Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. • Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. • Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. • Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. • Discuss, in a separate section, the approach to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. • Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. • Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. • Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. • (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. • (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. • Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. • Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. • Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. • Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. • Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. • Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. • Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. • (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. • (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. • Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. • Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. • Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. • Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. • Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs.
Appears in 1 contract
Samples: Cooperative Agreement
Proposal to Meet Program Requirements. The Project Narrative must include a proposal that explains the approach the applicant is considering to establish a State-operated Exchange. This section of the application will provide CCIIO with a high level overview of the State’s strategic plan to establish an Exchange, participate in the Federally-facilitated Exchange, or collaborate with the Federally-facilitated Exchange in a State Partnership model on certain activities. Regardless of the Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effort. In the proposal to meet program requirements, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be in alignment with the work planWork Plan and may provide a narrative description of the approach to achieve milestones or tasks outlined in the Work Plan. The applicant should describe how the Exchange will meet each of the program requirements set forth in this Funding Opportunity Announcement (see Section I.5). This proposal must include a description of the approach and the activities the State will undertake under each Exchange Establishment Core Area. If a State intends to apply for funds in certain Core Areas and not others, budgetthe applicant should provide a description of the activities it will undertake. For example, and budget narrative. Please complete to meet program requirements for performing Stakeholder Consultation, the proposal to meet program requirements based on must answer questions such as which stakeholders are involved in the Exchange model for establishment process, what roles the stakeholders have in the process, and how collaboration with stakeholders will continue throughout the establishment process. To answer questions such as these, the applicant could describe what forums will be used to engage with stakeholders, how stakeholder input will be gained and applied to inform the establishment process, and how the Exchange will identify stakeholders. Providing assistance to individuals and small businesses is a priority of the Exchange. Therefore, the proposal must address how the Exchange will work to meet the needs of consumers and ensure that these services are provided. In the discussion of the Exchange IT Systems Exchange Establishment Core Area, applicants must address how the Exchange will carry out due diligence in assessing the applicability of the system models developed by ―Early Innovator‖ States. If the applicant does not intend to use these models, this must be justified. (Awardees of Early Innovator Cooperative Agreements do not have to include this in their discussion.) States may choose to develop their own systems, which may be done in many ways, including use of commercial off the shelf products (COTS); or States may adapt systems developed by other States. Systems must be interoperable and/or integrated or interface with both the State is applying. Discuss the StateMedicaid and Children’s current Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness Health Insurance Program (CHIP) programs and be able to complete the applicable Exchange Activities. Discuss the State’s strategy to complete the Exchange Activities. Discuss any activities that the State must execute interface with HHS in order for a fully functional Exchange to operate in the Stateverify and acquire data as needed. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. Describe the if your proposed solution for Exchange IT Systems. Will this will be an independent application, an enhancement to existing functionality, or some other solution option? . Outline how tightly coupled the your proposed Exchange systems exchange will be with your existing Medicaid/CHIP Medicaid systems. Discuss States are encouraged to consider how the Exchange’s strategy Exchange system can be integrated with other health and human services systems in the state since the eligibility function the Exchange will perform has significant similarities to interface eligibility determinations in other programs. States are encouraged to consider how the Exchange system can be integrated with all other specific health and human services systems in the State since the eligibility function the Exchange will perform has significant similarities to eligibility determinations in other programs. Further, States are encouraged to consider steps necessary IT Systemsto achieve interoperability with other specific health and human services programs for purposes of coordinating eligibility determinations, including any information systems used referrals, verification or other functions. The proposal to regulate meet program requirements should explain how Exchange establishment will progress, leading to certification in January 2013, operation and provision of health insurance within the State and Medicaid/CHIP systems. IT Seven Standards and Conditions: Where applicable, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer coverage to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df Outline the organizational structure to support necessary activities related to the Exchange enrollees in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste2014, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones self-sustainability in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss, in a separate section, the approach to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs2015.
Appears in 1 contract
Samples: Cooperative Agreement
Proposal to Meet Program Requirements. This section of The Project Narrative must include a proposal that explains the application will provide CCIIO with a high level overview of approach the State’s strategic plan applicant is considering to establish an Exchange, participate . This section should be in alignment with the Work Plan and may provide a narrative description of the approach to achieve milestones or tasks outlined in the Federally-facilitated Exchange, or collaborate with Work Plan. The proposal should exhibit the Federally-facilitated State’s readiness to establish an Exchange in and place emphasis on how it has met the eligibility criteria for a State Partnership model on certain activitiesLevel Two Establishment award (Section III.
1.). Regardless The applicant should describe how the Exchange will meet each of the program requirements set forth in this Funding Opportunity Announcement (see Section I.5). This proposal must include a description of the approach and the activities the State will undertake under each Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effortEstablishment Core Area. In the proposal For example, to meet program requirementsrequirements for performing Stakeholder Consultation, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be answer questions such as which stakeholders are involved in alignment with the work planExchange establishment process, budgetwhat roles the stakeholders have in the process, and budget narrativehow collaboration with stakeholders will continue throughout the establishment process. Please complete To answer questions such as these, the applicant could describe what forums will be used to engage with stakeholders, how stakeholder input will be gained and applied to inform the establishment process, and how the Exchange will identify stakeholders. Providing assistance to individuals is a priority of the Exchange. Therefore, the proposal must address how the Exchange will work to meet program requirements based on the needs of consumers and ensure that these services are provided. In the discussion of the Exchange model for which the State is applying. Discuss the State’s current IT Systems Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness to complete the applicable Exchange Activities. Discuss the State’s strategy to complete Establishment Core Area, applicants must address how the Exchange Activitieswill carry out due diligence in assessing the applicability of the system models developed by ―Early Innovator‖ States. Discuss any activities that If the applicant does not intend to use these models, this must be justified. (Awardees of these grants do not have to include this in their discussion.) States may choose to develop their own systems, which may be done in many ways, including use of commercial off the shelf products (COTS); or States may adapt systems developed by other States. Systems must be interoperable and/or integrated or interface with State must execute Medicaid/Children’s Health Insurance Program (CHIP) programs and be able to interface with HHS in order for a fully functional Exchange to operate in the Stateverify and acquire data as needed. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. Describe the if your proposed solution for Exchange IT Systems. Will this will be an independent application, an enhancement to existing functionality, or some other solution option? . Outline how tightly coupled the your proposed Exchange systems exchange will be with your existing Medicaid/CHIP Medicaid systems. Discuss States are encouraged to consider how the Exchange’s strategy Exchange system can be integrated with other specific health and human services systems in the State since the eligibility function the Exchange will perform has significant similarities to interface eligibility determinations in other programs. Further, States are encouraged to consider steps necessary to achieve interoperability with all necessary IT Systemsother specific health and human services programs for purposes of coordinating eligibility determinations, including any information systems used referrals, verification or other functions. The proposal to regulate meet program requirements should explain how Exchange establishment will progress, leading to certification in January 2013, operation and provision of health insurance within the State and Medicaid/CHIP systems. IT Seven Standards and Conditions: Where applicable, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer coverage to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df Outline the organizational structure to support necessary activities related to the Exchange enrollees in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste2014, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones self-sustainability in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss, in a separate section, the approach to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs2015.
Appears in 1 contract
Samples: Cooperative Agreement to Support Establishment of State Operated Health Insurance Exchanges
Proposal to Meet Program Requirements. The Project Narrative must include a proposal that explains the approach the applicant is considering to establish a State-operated Exchange. This section of the application will provide CCIIO with a high level overview of the State’s strategic plan to establish an Exchange, participate in the Federally-facilitated Exchange, or collaborate with the Federally-facilitated Exchange in a State Partnership model on certain activities. Regardless of the Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effort. In the proposal to meet program requirements, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be in alignment with the work planWork Plan and may provide a narrative description of the approach to achieve milestones or tasks outlined in the Work Plan. The applicant should describe how the Exchange will meet each of the program requirements set forth in this Funding Opportunity Announcement (see Section I.5). This proposal must include a description of the approach and the activities the State will undertake under each Exchange Establishment Core Area. If a State intends to apply for funds in certain Core Areas and not others, budgetthe applicant should provide a description of the activities it will undertake. For example, and budget narrative. Please complete to meet program requirements for performing Stakeholder Consultation, the proposal to meet program requirements based on must answer questions such as which stakeholders are involved in the Exchange model for establishment process, what roles the stakeholders have in the process, and how collaboration with stakeholders will continue throughout the establishment process. To answer questions such as these, the applicant could describe what forums will be used to engage with stakeholders, how stakeholder input will be gained and applied to inform the establishment process, and how the Exchange will identify stakeholders. Providing assistance to individuals and small businesses is a priority of the Exchange. Therefore, the proposal must address how the Exchange will work to meet the needs of consumers and ensure that these services are provided. In the discussion of the Exchange IT Systems Exchange Establishment Core Area, applicants must address how the Exchange will carry out due diligence in assessing the applicability of the system models developed by ―Early Innovator‖ States. If the applicant does not intend to use these models, this must be justified. (Awardees of Early Innovator Cooperative Agreements do not have to include this in their discussion.) States may choose to develop their own systems, which may be done in many ways, including use of commercial off the shelf products (COTS); or States may adapt systems developed by other States. Systems must be interoperable and/or integrated or interface with both the State is applying. Discuss the StateMedicaid and Children’s current Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness Health Insurance Program (CHIP) programs and be able to complete the applicable Exchange Activities. Discuss the State’s strategy to complete the Exchange Activities. Discuss any activities that the State must execute interface with HHS in order for a fully functional Exchange to operate in the Stateverify and acquire data as needed. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. Describe the if your proposed solution for Exchange IT Systems. Will this will be an independent application, an enhancement to existing functionality, or some other solution option? . Outline how tightly coupled the your proposed Exchange systems exchange will be with your existing Medicaid/CHIP Medicaid systems. Discuss States are encouraged to consider how the Exchange’s strategy Exchange system can be integrated with other health and human services systems in the state since the eligibility function the Exchange will perform has significant similarities to interface eligibility determinations in other programs. States are encouraged to consider how the Exchange system can be integrated with all necessary IT Systems, including any information other specific health and human services systems used to regulate health insurance within in the State and Medicaid/CHIP systems. IT Seven Standards and Conditions: Where applicable, discuss how compliance with since the Medicaid’s Seven Standards and Conditions will be incorporated into eligibility function the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer will perform has significant similarities to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df Outline the organizational structure to support necessary activities related to the Exchange eligibility determinations in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. DiscussFurther, in a separate section, the approach States are encouraged to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan consider steps necessary to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration interoperability with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs.other
Appears in 1 contract
Samples: Cooperative Agreement
Proposal to Meet Program Requirements. The Project Narrative must include a proposal that explains the approach the applicant is considering to establish a State-operated Exchange. This section should be in alignment with the Work Plan and may provide a narrative description of the application will provide CCIIO with a high level overview of approach to achieve milestones or tasks outlined in the Work Plan. The proposal should exhibit the State’s strategic plan readiness to establish an Exchange, participate in Exchange and place emphasis on how it has met the Federally-facilitated Exchange, or collaborate with eligibility criteria for a Level Two Establishment award (Section III.
1.). The applicant should describe how the Federally-facilitated Exchange in a State Partnership model on certain activities. Regardless will meet each of the program requirements set forth in this Funding Opportunity Announcement (see Section I.5). This proposal must include a description of the approach and the activities the State will undertake under each Exchange model a State wishes to pursue- either short or long-term- CCIIO is prepared to tailor each Cooperative Agreement to a State to meet the needs of their consumers and will use this section to continue a strong collaborative effortEstablishment Core Area. In the proposal For example, to meet program requirementsrequirements for performing Stakeholder Consultation, the applicant should discuss the overall strategy of a State to fulfill the required Exchange Activities. A State that plans to transition or is transitioning between Exchange models or where responsibility for specific activities is changing should provide a timeline for changing models or transferring ownership of activities. The proposal to meet program requirements should be answer questions such as which stakeholders are involved in alignment with the work planExchange establishment process, budgetwhat roles the stakeholders have in the process, and budget narrativehow collaboration with stakeholders will continue throughout the establishment process. Please complete To answer questions such as these, the applicant could describe what forums will be used to engage with stakeholders, how stakeholder input will be gained and applied to inform the establishment process, and how the Exchange will identify stakeholders. Providing assistance to individuals is a priority of the Exchange. Therefore, the proposal must address how the Exchange will work to meet program requirements based on the needs of consumers and ensure that these services are provided. In the discussion of the Exchange model for which the State is applying. Discuss the State’s current IT Systems Exchange pathway. Please discuss the anticipated date for establishment of a State-based Exchange based on the State’s self assessment of readiness to complete the applicable Exchange Activities. Discuss the State’s strategy to complete Establishment Core Area, applicants must address how the Exchange Activitieswill carry out due diligence in assessing the applicability of the system models developed by ―Early Innovator‖ States. Discuss any activities that If the applicant does not intend to use these models, this must be justified. (Awardees of these grants do not have to include this in their discussion.) States may choose to develop their own systems, which may be done in many ways, including use of commercial off the shelf products (COTS); or States may adapt systems developed by other States. Systems must be interoperable and/or integrated or interface with State must execute Medicaid/Children’s Health Insurance Program (CHIP) programs and be able to interface with HHS in order for a fully functional Exchange to operate in the Stateverify and acquire data as needed. Please refer to Appendix A for a breakdown of activities and ownership responsibilities. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, should complete. Describe the if your proposed solution for Exchange IT Systems. Will this will be an independent application, an enhancement to existing functionality, or some other solution option? . Outline how tightly coupled the your proposed Exchange systems exchange will be with your existing Medicaid/CHIP Medicaid systems. Discuss States are encouraged to consider how the Exchange’s strategy Exchange system can be integrated with other specific health and human services systems in the State since the eligibility function the Exchange will perform has significant similarities to interface eligibility determinations in other programs. Further, States are encouraged to consider steps necessary to achieve interoperability with all necessary IT Systemsother specific health and human services programs for purposes of coordinating eligibility determinations, including any information systems used referrals, verification or other functions. The proposal to regulate meet program requirements should explain how Exchange establishment will progress, leading to certification in January 2013, operation and provision of health insurance within the State and Medicaid/CHIP systems. IT Seven Standards and Conditions: Where applicable, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement development, design and build process. The seven conditions and standards include (1) modularity; (2) Medicaid Information Technology Architecture (MITA) alignment; (3) leverage and reuse within and among States; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Please refer coverage to the most recent IT Guidance for more information. IT Guidance 2.0 can be found at: xxxx://xxxxx.xxx.xxx/resources/files/exchange_medicaid_it_guidance_05312011.p df Outline the organizational structure to support necessary activities related to the Exchange enrollees in the State. Include a discussion of the strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other State agencies such as the State Medicaid agency. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities. This includes, but is not limited to, coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with the Center for Medicaid and CHIP Services (CMCS) and CCIIO. Discuss strategies for reuse, sharing and collaboration (beyond Exchange IT systems) for Exchange Activities that currently exist within your State, the Federal Exchange, or other States as applicable. The discussion of IT Systems reuse should be addressed in the response to the description of the proposed solution for Exchange IT Systems. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste2014, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones self-sustainability in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss, in a separate section, the approach to be taken in establishing the State’s SHOP. Please assess the market challenges in building a successful SHOP and describe a strategic SHOP plan to achieve effective competition, a level playing field inside and outside the SHOP, a broad choice of issuers and plans, effective implementation of employee choice, an appealing and efficient shopping and enrollment experience for employers and employees, effective engagement of the broker community in SHOP education and enrollment, efficient back office operations, and effective customer support. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in partnership within the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If applicable, please discuss the State’s possible intentions to eventually establish a State-based Exchange. Please discuss the anticipated date for establishment of a State-based Exchange or collaboration with the Federally-facilitated Exchange in a State Partnership model based on the State’s self assessment of readiness to complete the activities required for the proposed Exchange model. Discuss the Partnership activities that the State intends to or will be responsible for and how it will collaborate with the Federal government in a State Partnership model around other activities. Please refer to Appendix B for a breakdown of activities and ownership responsibilities under the State Partnership model. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the Exchange in the State. Include a discussion of strategy to engage with counterparts in the State. For example, if the State Department of Insurance is an applicant, describe how it will interact with other appropriate State agencies. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities that are specific to the Partnership model (Plan Management and/or Consumer Assistance). This includes but is not limited to coordination between the State Department of Insurance and CCIIO as well as the State Medicaid Agency with CMS. Discuss strategies for xxxxx, sharing and collaboration around the Partnership activities. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs. Discuss the State’s current Exchange pathway. CCIIO recognizes that some states may initially participate in the Federally-facilitated Exchange, but may eventually move to a State-based Exchange model. If participating in the Federally-facilitated Exchange, please discuss the States future intentions to either begin collaborating with the Federally-facilitated Exchange in a State Partnership model and/or to eventually establish a State-based Exchange. Discuss the State’s strategy to address the early benchmarks identified in Section I.4. These elements are identified as the early benchmarks that all States, regardless of model, must complete by specific dates. (If applicable) Describe any IT Systems or interfaces the State will develop to ensure functionality of the Federally-facilitated Exchange within the State and the ability to interface with State IT Systems. Discuss the States strategy to interface all necessary State IT Systems, including insurance regulation information systems (i.e. for transmission of necessary information about issuers) and Medicaid/CHIP systems, with the FFE. (If applicable) IT Seven Standards and Conditions: Where applicable because of the state’s long term plans, discuss how compliance with the Medicaid’s Seven Standards and Conditions will be incorporated into the Exchange requirement, design and build process. The seven conditions and standards include (1) modularity; (2) MITA alignment; (3) leverage and reuse within and among states; (4) industry standard alignment; (5) support of business results; (6) reporting; and (7) seamlessness and interoperability. Outline the organizational structure to support necessary activities related to the establishment of the Federally-facilitated Exchange in the State. Include a discussion of the strategy to engage with appropriate counterparts in the State. If there is not a Memorandum of Understanding, Memorandum of Agreement, or other formal agreement in place, please discuss the plans for such an agreement to support completion of all Work Plan benchmarks and activities. Discuss how appropriate State entities will coordinate with the Federal government on Exchange activities related to the Federally-facilitated Exchange including but not limited to sharing of data, coordination of State and Federal policies impacting execution of Exchange activities, etc. Discuss any strategies for reuse, sharing and collaboration within your State or other States as applicable. Discuss strategies to ensure financial integrity mechanisms are in place to prevent fraud, waste, and abuse and to provide oversight of Cooperative Agreement funds and the Exchange. Discuss challenges that may affect progress against milestones in the Work Plan. Please include a discussion of how the State plans to mitigate these challenges, including organizational challenges associated with change management, such as the implementation of new processes and protocols and gaining traction when initiating new collaboration between agencies and programs2015.
Appears in 1 contract
Samples: Cooperative Agreement
