Department of Health & Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) Transmittal 895 Date: May 6, 2011

Transcription

1 anual ystem Pub One-Time Notification epartment of ealth & uman ervices () enters for edicare & edicaid ervices () Transmittal 895 ate: ay 6, 2011 hange equest 7362 UJT: evisions to hange equest () 7054: ntegrated ata epository () laims ourcing from hared ystems mplementation ased on onference alls and urther esearch. UY O NG: The hared ystems () will receive feeds from the three shared systems - the, and. n addition to daily feeds, the will also receive history extracts containing historical data starting with October To facilitate transmitting the history extract through N, this requires the hared ystems aintainers to break the history extracts into smaller segments. The N can support transmission of files up to 120G. dditionally, this requires the hared ystems aintainers to update their aster data dictionaries to be consistent with the approved definitions. T T: October 1, 2011 PLNTTON T: October 3, 2011 isclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. ny other material was previously published and remains unchanged. owever, if this revision contains a table of contents, you will receive the newrevised information only, and not the entire table of contents.. NG N NUL NTUTON: (N if manual is not updated) =, N=N, =LT- N N PT TON UTON TTL. UNNG: or iscal ntermediaries (s), egional ome ealth ntermediaries (s) andor arriers: No additional funding will be provided by ; contractor activities are to be carried out within their operating budgets. or edicare dministrative ontractors (s): The edicare dministrative ontractor is hereby advised that this constitutes technical direction as defined in your contract. does not construe this as a change to the tatement of ork. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the ontracting Officer. f the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question

2 and immediately notify the ontracting Officer, in writing or by , and request formal directions regarding continued performance requirements.. TTNT: One-Time Notification *Unless otherwise specified, the effective date is the date of service.

3 ttachment One-Time Notification Pub Transmittal: 895 ate: ay 6, 2011 hange equest: 7362 UJT: evisions to hange equest () 7054: ntegrated ata epository () laims ourcing from hared ystems mplementation ased on onference alls and urther esearch ffective ate: October 1, mplementation ate: October 3, GNL NOTON. ackground: The hared ystems () will receive feeds from the three shared systems the, and. pecifically, the nterprise ata enters (s) will send files for each shared system that are based on the copybooks the shared systems maintainers currently provide to the hared ystems Team. Once files are received, the enters for edicare & edicaid ervices () requires the to perform a file consistency validation on each file sent by the shared systems prior to accepting the file and to retain the files at the altimore ata enter (). n addition to the daily feeds, the will also receive history extracts containing historical data starting with October To facilitate transmitting the history extract through N, requires changes to the shared systems files and submission processes. This requires the hared ystems aintainers to break the history extracts into smaller segments to allow the file transmission via N for loading into the. The N can support transmission of files up to 120G. dditionally, this requires the hared ystems aintainers to update their aster data dictionaries to be consistent with the approved definitions.. Policy: The edicare Program ntegrity Group has determined that it will use the hared ystems claims data for fraud, waste and abuse detection.. UN QUNT TL Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT hared ystems aintainers shall send the history from each workload via N in at least two parts: 1) October 2010 to current go-live date 2) October 2005 to eptember hared ystems aintainers shall split the history extracts into smaller segments as needed, based on: 1) ate (files should be broken down by fiscal year), and 2) ize limitation (maximum file size 120G for N)

4 Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT The ata enters shall assign unique names to the history files produced from each workload, such that the filename has the following format: The following file naming convention shall be used: T nbound ile Naming onvention: P#T.ON..#NNNNN.TT.YY.T T pplication nbound ile Naming onvention: P#.N.T.#NNNNN.TT.YY.T T here: - P = ile extract instance P Production extract file evelopment extract file T Test extract file - # = the shared system sending the file NNNNN = orkloadystem or ontractor Number as described in TT = ile type 1 = istory n-process Phase ( and ) 2 = istory n-process Phase ( and ) 3 = istory Phase = N istory = P istory = ynamic istory = tatic istory - = iscal Year (xample 06 for ) - = ile counter (e.g. if file for year 06 is split to 5 files based on the file size, the counter will be from 01 to 05) - YY.TT = The T process will modify the date and timestamp of the filename. The time inserted will be astern tandard Time. xamples: - T nbound ile Name (Production): P#T.ON T pplication nbound ile Name (Production): P#.N.T T

5 Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT The following orkloadystem s and ontractor Numbers shall be used in the file names: P YL PTON OKLO UNT ONTTONOT Part J Palmetto G Part J Palmetto G Legacy Part J Noridian Part J Traillazer Legacy Part J P Part J12 Legacy ighmark prod cutover Part J N Part J N Part J N (egion ) Part J N NT Part J GN prod cutover Part N Noridian Part Legacy (4 separate prod cycles) P; NOT- our cycles are used to process the Legacy workload and therefore 4 sets of files will be created, however, there is only 1 workload number. The s, and team shall determine a convention for distinguishing the 4 cycles. Part L NG Part NG Part egion (+) NG

6 Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT Part egion Part J14 N T Part J14 Part J1 N. Part J1. Part J1 N Part J3 NY Part J3 ZUTT Part J5 KNO Part ail ahaba G; this cycle will be archived when the workload transitions to J15 on N N Palmetto G Palmetto G Palmetto G Noridian Noridian P; is the rollup number, however, is currently used for the GL interface, which is the individual workload number for. Palmetto G oad Part N P Part L P Part P J N J NG J GN J Noridian orkload Numbers orkload ontra ctor Numbe r s c tiv e s Pre utove r Gr ou p ta te o de Part J13 - TNY T 13

7 Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT J4 - oloradonew exico Texas T 41 J4 - Oklahoma T 42 J9 - lorida T 91 J9 - Puerto ico T 92 J10 - Georgia T 1 J10 - Tennessee T 2 J10 - labama T 3 J12 - elaware T 4 J12 - NJP T 5 ndiana T N Kentucky T KY ichigan T rkansaslouis iana ississippi T J11 - North arolina T N Ohio T O outh arolina T irginia. irginia T 1 laskaashin gton Oregon daho T Part J10 - labama T 10 J10 - Georgia T 10 J10 - Tennessee T 10 J13 - onneticutt T 13 J13 - New York T 13 J13 - New York upstate T 13 J13 - Newy York Queens T 13 J4 - Texas T 41 J4 - Oklahoma T 44 J4 - New exico T 44

8 Number equirement esponsibility (place an X in each applicable hared-ystem aintainers OT J4 - olorado T 44 J9 - lorida T 91 J9 - Puerto ico T 92 J9 - irgin slands T 92 laskaoregon ashington - ap rug T K laska T K Oregon T K ashington T K rkansas T J12 - Pennsylvania T 1 J12 - New Jersey T 2 J12 - aryland T 3 J12 - elaware T 4 daho (split) T 2 ndiana T N Kentucky T N Louisiana T L ississippi T 1 ichigan T North arolina T N Ohio T O est irginia T O outh arolina T irginia T The ata enters shall send the full file names created at the receiving data center to via secure upon generating the files The ata enters, via secure and upon transmission of the files, shall notify the implementation team of the total number of history files from each workload as validation that all files are received The hared ystem aintainers shall update their aster data dictionaries to be consistent with the approved data element definitions and code values and definitions.

9 . PO UTON TL Number equirement esponsibility (place an X in each applicable hared-ystem aintainers None OT. UPPOTNG NOTON ection : or any recommendations and supporting information associated with listed requirements, use the box below: Use "hould" to denote a recommendation. X-ef equireme nt Number N ecommendations or other supporting information: ection : or all other recommendations and supporting information, use this space: N. ONTT Pre-mplementation ontact(s): nthony odge at or nthony.odge3@cms.hhs.gov John tewart at or John.tewart@cms.hhs.gov Patte ppling at or Patricia.ppling@cms.hhs.gov Post-mplementation ontact(s): ontact your ontracting Officer s Technical epresentative (OT) or ontractor anager, as applicable.. UNNG ection : or iscal ntermediaries (s), egional ome ealth ntermediaries (s), andor arriers: No additional funding will be provided by ; contractor activities are to be carried out within their operating budgets. ection : or edicare dministrative ontractors (s): The edicare dministrative ontractor is hereby advised that this constitutes technical direction as defined in your contract. does not construe this as a change to the tatement of ork. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the ontracting Officer. f the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and

10 immediately notify the ontracting Officer, in writing or by , and request formal directions regarding continued performance requirements.