1

NATIONAL PROVIDER IDENTIFIER (NPI) CLOSEOUT PHASE

Human Services Department

• Mark Pitcock, Bureau Chief • Program Information Systems Bureau

• Liz Shaw, IT Project Manager • Information Technology Department

2

NPI Project Overview

Meets the Federal requirement for a National Provider Identifier for HIPAA-covered health care providers and insurers

NPI will generate efficiencies in the health care system Changes were required for the existing Omnicaid (Medicaid claims adjudication

system) and the Transaction Interface Exchange (HIPAA transactions translator) Omnicaid is hosted by ACS, fiscal agent for HSD’s Medicaid Management

Information System. The software is maintained by ACS. TIE is hosted at NM DoIT Data Center. The software is maintained by HSD/ITD.

Funded from the computer enhancement fund reauthorized Laws 2007, Chapter 28, Section 7, Subsection 20 Dept. of Health & Human Services; Centers for Medicare & Medicaid

Services. Grant # 0805NM5028

3

NPI Accomplishments Initiation Phase: Completed by December 2006

NPI System Assessment completed – this assessment was to determine which identification number locations and logic must be modified to accommodate the new HIPAA standards)

High Level Project Plan Advanced Planning Document Initiation Phase Certification

Implementation Phase: Completed by June 2008 NPI software changes to Omnicaid put into Production - May 23, 2007 IV&V reports for Omnicaid-related work - completed by June 2007 IV&V reports for TIE-related work – completed by June 2008 TIE-related coding and configuration and end-to-end testing – completed

by June 2008 System documentation and training – completed by June 2008 TIE software changes put into Production – June 30, 2008

4

NPI Next Steps Update system documentation, November 2008

PCC approval of project certification for Close-out Phase, November 2008

Submit close-out report to DoIT, December 2008

Submit APD Update to CMS, December 2008

5

Lessons Learned A solid project plan should be created and followed Stronger contractual management Create a Project Management Office for such large

projects that involve several groups. This would also help to control off-site, disparate teams and to create a more collaborative effort.

Make sure that the project has adequate, cross-functional resources

HSD needs to be part of an integrated coding team, to ensure that our coding requirements are met