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NEW MEXICO HUMAN SERVICES DEPARTMENT
REQUEST FOR PROPOSALS
Integration Platform Services for MMISR Project
Amendment #4
RFP#
17-630-4000-1001
Amendment #4 Issued: October 5, 2016
Original RFP Issued: August 25, 2016
Submissions Due: October 21, 2016
Request for Proposal Number 17-630-4000-1001 is amended as described herein:
1. Change to The MMISR Modular Procurements section 1b, page 15:
Removal of reference of EDW in the Data Services section.
From:
1. The MMISR Modular Procurements
a. Integration Platform – Through this IP procurement, HSD will acquire the
core technologies and associated services needed to support and implement
the remainder of the MMISR solution, including:
1) The enterprise service bus (ESB) that forms the central integrating
technology for our modular services and technology architecture;
2) A number of technology applications and tools that support programmatic
needs within the HHS 2020 framework (e.g., master index, monitoring
tools);
3) Essential data-related infrastructure, including:
a) Implementation of operational/production database(s) needed to
monitor IP solution performance, support MMIS transition, serve on-
going operational requirements and feed data to an enterprise data
warehouse (EDW) (or other repository(s) that support reporting and
analytics), and
b) Infrastructure for the Data Services (DS) procurement;
4) Contractor services to implement and operate the IP;
5) Contractor services to facilitate and ensure successful integration of
subsequent modules and components, and to plan and lead conversion
from the legacy MMIS to the new MMISR solution to meet CMS
Certification requirements;
6) Contractor services to provide support to the State’s HHS 2020 Project
Management Organization (PMO);
7) Contractor services to manage the IP contract and interact with the State
and other HHS 2020 contractors to support HHS 2020 and MMISR.
b. Data Services (DS) – The Data Services procurement is focused on
designing, implementing, operating and continually improving the structures,
processes and data needed to support HSD – and HHS 2020 – current and
future reporting and analytics requirements. The DS Contractor will develop
data structures – e.g., EDW, multiple linked data stores, data marts, data lakes
– leveraging infrastructure provided through the IP contract.
HSD anticipates the DS Contractor will focus initially on defining and
implementing the processes, analytics and technology tools and structures
required to establish a foundational integrated data solution that supports
reporting and analytics. However, the module goals also include providing
insightful analytics to support population health management (i.e., an
outcomes-focused approach to designing, delivering and managing services,
with the ability to run New Mexico-specific experience against national
databases) and to enable HHS enterprise-wide reporting and analytics through
an integrated data, services and technology platform. The DS Contractor will
also deliver timely and accurate reports, analytics and related work products
using the DS solution.
The DS Contractor also will be responsible for analyzing data requirements,
both current and projected; working with the State to define and implement an
enterprise data governance approach; planning and implementing Master Data
Management (MDM) for HHS 2020 data assets; providing data analytic and
Business Intelligence tools and working with the State to plan an approach to
achieve increasing levels of data maturity for HHS 2020.
c. Financial Services (FS) – HSD will contract with a BPO vendor to obtain
claims processing and comprehensive financial services (e.g., accounting,
payment handling) using a CMS-compliant platform and processes. The FS
contractor also will provide services necessary for managing the FS contract,
for interacting with the State and other HHS 2020 contractors to effectively
support HHS 2020 and MMISR, and for providing to the IP and Data Service
contractors the data elements essential to federal reporting requirements.
d. Quality Assurance (QA) – Through a BPO contract, HSD will contract with
a vendor to obtain and perform the following services for the QA module
using a CMS-compliant platform and processes:
1) Program Integrity support, including Third-Party Liability (TPL), Fraud
and Abuse Detection Services, audit coordination, quality reporting, and
compliance;
2) Provider enrollment and management;
3) Management of Prior Approval, and Recovery and Audit responsibilities;
4) Manage the QA contract and interact with the State and other HHS 2020
contractors to effectively support HHS 2020 and the MMISR Project; and
5) Coordinate efforts and projects with the HSD Office of Inspector General
(OIG) and the Medicaid Fraud Control Unit (MFCU) of the Office of the
Attorney General.
e. Population Health Management (PHM) – PHM represents realization of a
vision for an outcomes-focused approach to serving the needs of New Mexico
citizens and to managing and delivering services and benefits. PHM will be
realized through a combination of services and information available through
the other elements of the MMISR solution. Through the PHM module
procurement, HSD will obtain through a vendor the services listed below:
1) Pharmacy benefits management (including rebate services);
2) Assistance with Managed Care Organization (MCO) management;
3) Focused analytics and datasets related to population health, outcomes and
health improvement;
4) Coordination of the Electronic Health Records initiative;
5) Assistance with the systems and data support necessary for effective care
and case management; and
6) Changes to the Fee-for-Service (FFS) program.
The PHM module contractor also will perform services necessary to manage
the PHM contract and to interact with the State and with other HHS 2020
module contractors to effectively support HHS 2020 and the MMISR Project.
f. Unified Public Interface (UPI) – A key element of the HHS 2020
framework is a unified interface serving all stakeholders, in keeping with the
vision of presenting a more customer-centric view of HHS services and
processes. For this module HSD plans to procure contractor services to
develop, implement and operate a UPI serving New Mexico citizens,
providers, state agencies and employees, and other stakeholders. The goal of
the UPI is to offer a “one-stop shop” that embraces a “no wrong door”
approach to customer service.
The State is evaluating the procurement approach to achieve this goal. The
State’s current plan is to separately acquire two principal UPI components.
1) Consolidated Customer Service Center (CCSC) – The goal for the CCSC
is to provide a single, integrated contact center serving all HSD programs,
to increase efficiency and to make it easier for our customers and
providers to obtain needed information and/or actions. HSD intends to
procure the CCSC through a BPO contract that will encompass:
a) CCSC set-up/tailoring to meet HSD-specific needs, including
technology, processes, training and staff;
b) CCSC operation, reporting and continuous improvement; and
c) Services necessary to manage the CCSC contract and to interact with
the State and with other HHS 2020 contractors to effectively support
HHS 2020 and MMISR.
2) Unified Web Portal and Mobile Technology – The second principal UPI
component encompasses both a unified web portal and the use of social
media, mobile technology and other user-friendly technologies to improve
user ease of access and to enhance HSD’s ability to readily and effectively
reach customers, providers or other stakeholders. Work associated with
this component includes:
a) Development of a comprehensive concept and design to effectively
serve all stakeholders, via web portal(s), mobile technology, and other
user-friendly technologies;
b) Implement, operate and maintain the unified portal(s) and other
recommended technologies; and
c) Services needed to manage this component and to interact with the
State and with other HHS 2020 contractors to effectively support HHS
2020 and MMISR.
In addition to these procurements, HSD released a competitive procurement in
2015 for MMISR IV&V services. The State has selected a finalist and anticipates
the vendor to begin operations in July 2016. The MMISR IV&V Contractor will
perform IV&V services throughout MMISR implementation and CMS
Certification, in accordance with CMS and NM Department of Information
Technology (DoIT) requirements. All MMISR module prime contractors will be
required to interact and collaborate with the IV&V Contractor.
To:
1. The MMISR Modular Procurements
a. Integration Platform – Through this IP procurement, HSD will acquire the core
technologies and associated services needed to support and implement the
remainder of the MMISR solution, including:
1) The enterprise service bus (ESB) that forms the central integrating
technology for our modular services and technology architecture;
2) A number of technology applications and tools that support programmatic
needs within the HHS 2020 framework (e.g., master index, monitoring
tools);
3) Essential data-related infrastructure, including:
a) Implementation of operational/production database(s) needed to
monitor IP solution performance, support MMIS transition, serve on-
going operational requirements and feed data to an enterprise data
warehouse (EDW) (or other repository(s) that support reporting and
analytics), and
b) Infrastructure for the Data Services (DS) procurement;
4) Contractor services to implement and operate the IP;
5) Contractor services to facilitate and ensure successful integration of
subsequent modules and components, and to plan and lead conversion
from the legacy MMIS to the new MMISR solution to meet CMS
Certification requirements;
6) Contractor services to provide support to the State’s HHS 2020 Project
Management Organization (PMO);
7) Contractor services to manage the IP contract and interact with the State
and other HHS 2020 contractors to support HHS 2020 and MMISR.
b. Data Services (DS) – The Data Services procurement is focused on
designing, implementing, operating and continually improving the structures,
processes and data needed to support HSD – and HHS 2020 – current and
future reporting and analytics requirements. The DS Contractor will develop
data structures – e.g., multiple linked data stores, data marts, data lakes –
leveraging infrastructure provided through the IP contract.
HSD anticipates the DS Contractor will focus initially on defining and
implementing the processes, analytics and technology tools and structures
required to establish a foundational integrated data solution that supports
reporting and analytics. However, the module goals also include providing
insightful analytics to support population health management (i.e., an
outcomes-focused approach to designing, delivering and managing services,
with the ability to run New Mexico-specific experience against national
databases) and to enable HHS enterprise-wide reporting and analytics through
an integrated data, services and technology platform. The DS Contractor will
also deliver timely and accurate reports, analytics and related work products
using the DS solution.
The DS Contractor also will be responsible for analyzing data requirements,
both current and projected; working with the State to define and implement an
enterprise data governance approach; planning and implementing Master Data
Management (MDM) for HHS 2020 data assets; providing data analytic and
Business Intelligence tools and working with the State to plan an approach to
achieve increasing levels of data maturity for HHS 2020.
c. Financial Services (FS) – HSD will contract with a BPO vendor to obtain
claims processing and comprehensive financial services (e.g., accounting,
payment handling) using a CMS-compliant platform and processes. The FS
contractor also will provide services necessary for managing the FS contract,
for interacting with the State and other HHS 2020 contractors to effectively
support HHS 2020 and MMISR, and for providing to the IP and Data Service
contractors the data elements essential to federal reporting requirements.
d. Quality Assurance (QA) – Through a BPO contract, HSD will contract with
a vendor to obtain and perform the following services for the QA module
using a CMS-compliant platform and processes:
1) Program Integrity support, including Third-Party Liability (TPL), Fraud
and Abuse Detection Services, audit coordination, quality reporting, and
compliance;
2) Provider enrollment and management;
3) Management of Prior Approval, and Recovery and Audit responsibilities;
4) Manage the QA contract and interact with the State and other HHS 2020
contractors to effectively support HHS 2020 and the MMISR Project; and
5) Coordinate efforts and projects with the HSD Office of Inspector General
(OIG) and the Medicaid Fraud Control Unit (MFCU) of the Office of the
Attorney General.
e. Population Health Management (PHM) – PHM represents realization of a
vision for an outcomes-focused approach to serving the needs of New Mexico
citizens and to managing and delivering services and benefits. PHM will be
realized through a combination of services and information available through
the other elements of the MMISR solution. Through the PHM module
procurement, HSD will obtain through a vendor the services listed below:
1) Pharmacy benefits management (including rebate services);
2) Assistance with Managed Care Organization (MCO) management;
3) Focused analytics and datasets related to population health, outcomes and
health improvement;
4) Coordination of the Electronic Health Records initiative;
5) Assistance with the systems and data support necessary for effective care
and case management; and
6) Changes to the Fee-for-Service (FFS) program.
The PHM module contractor also will perform services necessary to manage
the PHM contract and to interact with the State and with other HHS 2020
module contractors to effectively support HHS 2020 and the MMISR Project.
f. Unified Public Interface (UPI) – A key element of the HHS 2020
framework is a unified interface serving all stakeholders, in keeping with the
vision of presenting a more customer-centric view of HHS services and
processes. For this module HSD plans to procure contractor services to
develop, implement and operate a UPI serving New Mexico citizens,
providers, state agencies and employees, and other stakeholders. The goal of
the UPI is to offer a “one-stop shop” that embraces a “no wrong door”
approach to customer service.
The State is evaluating the procurement approach to achieve this goal. The
State’s current plan is to separately acquire two principal UPI components.
1) Consolidated Customer Service Center (CCSC) – The goal for the CCSC
is to provide a single, integrated contact center serving all HSD programs,
to increase efficiency and to make it easier for our customers and
providers to obtain needed information and/or actions. HSD intends to
procure the CCSC through a BPO contract that will encompass:
a) CCSC set-up/tailoring to meet HSD-specific needs, including
technology, processes, training and staff;
b) CCSC operation, reporting and continuous improvement; and
c) Services necessary to manage the CCSC contract and to interact with
the State and with other HHS 2020 contractors to effectively support
HHS 2020 and MMISR.
2) Unified Web Portal and Mobile Technology – The second principal UPI
component encompasses both a unified web portal and the use of social
media, mobile technology and other user-friendly technologies to improve
user ease of access and to enhance HSD’s ability to readily and effectively
reach customers, providers or other stakeholders. Work associated with
this component includes:
a) Development of a comprehensive concept and design to effectively
serve all stakeholders, via web portal(s), mobile technology, and other
user-friendly technologies;
b) Implement, operate and maintain the unified portal(s) and other
recommended technologies; and
c) Services needed to manage this component and to interact with the
State and with other HHS 2020 contractors to effectively support HHS
2020 and MMISR.
In addition to these procurements, HSD released a competitive procurement in
2015 for MMISR IV&V services. The State has selected a finalist and anticipates
the vendor to begin operations in July 2016. The MMISR IV&V Contractor will
perform IV&V services throughout MMISR implementation and CMS
Certification, in accordance with CMS and NM Department of Information
Technology (DoIT) requirements. All MMISR module prime contractors will be
required to interact and collaborate with the IV&V Contractor.
2. Change to APPENDIX G – NM HHS 2020 – INTEGRATION PLATFORM
DETAILED STATEMENT OF WORK, page 84:
Removal of reference of EDW in the section 3 Database in relation to the Operational Data
Store (ODS).
From:
APPENDIX G - NM HHS 2020 - INTEGRATION PLATFORM
DETAILED STATEMENT OF WORK
This APPENDIX contains the Statement of Work. The Statement of Work is a
companion document to the requirements found in APPENDIX H, and should be read
and interpreted as a statement of both expectation and explanation of requirements
found in APPENDIX H.
1. IP CONTRACTOR ROLE
a. KEY ROLE
The IP Contractor is central to successful MMISR implementation and operation. The IP
Contractor will have a dual role:
Design, implement, maintain and operate the IP solution, which includes the ESB,
enterprise technology service components, tools, the production database(s), data
warehouse and ODS, and infrastructure to support enterprise data and interfaces; and
Work with the State to lead and coordinate the planning, management and successful
integration of the remaining MMISR vendor modules and components.
b. IP SOLUTION AND APPROACH
HSD is seeking a solution and a service-delivery approach that:
Effectively addresses the HHS 2020 vision and the chosen approach to MMISR,
while identifying risks or trade-offs and making informed recommendations for an
approach that blends the “best” use of technology and related processes, with cost-
effective implementation, maintenance and operation – including consideration of
sustainability, flexibility, maximized reuse and interoperability;
Demonstrates experience with the technologies, challenges, compliance
requirements, and opportunities associated with the recommended solution and
service-delivery approach;
Demonstrates a well-established understanding and application of proven
management, system engineering, testing, training and other applicable processes;
Credibly explains how the resources (including any subcontractors) will effectively
work as a single team to meet State requirements;
Explains how the IP solution, and the associated integration of the subsequent
MMISR vendor modules, will be planned and executed to enable successful
completion within a very aggressive time frame; and
Explains how the Contractor will manage interactions with HSD, with disparate state
and federal stakeholders, and with other involved vendors to deliver and operate an
MMISR solution comprising multiple modules.
c. COMPLETE SOLUTION
Offerors are responsible for proposing a complete Integrated Platform solution, including
all components of the IP architecture necessary to handle capacity and performance
requirements throughout the contract life, and an approach to delivering all services
required to complete all life cycle phases and responsibilities related to the IP contract.
Offerors should propose an IP architectural solution that is geared to the intent of the
HHS 2020 framework (see APPENDIX G, Section III). Offerors may propose alternative
technologies to those listed, but should explain how these serve HSD requirements and
why they are advantageous to HSD.
Offerors must propose an approach to implement and operate the IP solution that will
also use the IP solution to enable a functional MMISR solution across all involved
modules and contractors. While NOT responsible for the work of other MMISR module
contractors, the IP Contractor will be responsible for setting standards that apply across
the whole MMISR solution; for facilitating problem diagnosis and resolution across the
integrated solution; and for providing guidance, review, testing, coordination and
troubleshooting as additional MMISR contracts are awarded and modules are
implemented.
A key deliverable under this contract is an MMISR Migration Plan documenting the
approach that will be taken to migrate from the legacy MMIS to the new, multiple-
module, multiple-contractor MMISR solution on a very tight timeline. Offerors should
describe how this plan will be developed, how risks associated with the migration will be
mitigated or minimized, how continuity of operations (COO) will be maintained, how
legacy system data will be tested and validated, and the factors that will determine the
proposed sequencing, migration processes, timelines, and responsibilities that must be
incorporated in this plan.
Offerors should frame their IP solution and approach in context of the HHS 2020 vision,
of HSD’s goal of obtaining Medicaid Information Technology Architecture (MITA)
maturity level 4, and of the CMS Seven Conditions and Standards (SCS). HSD may, as
planning evolves, request the Contractor to extend support to the CSESR project, or to
other HHS 2020 initiatives, in the future to the extent that these initiatives align with and
benefit from the HHS 2020 framework.
The IP Contractor will be responsible for supporting HSD through the CMS MMIS
certification process, ensuring that the IP solution meets certification requirements, that
each subsequent module will address those requirements, and that the MMISR solution
as a whole can be certified. The MMISR project will follow the CMS Enterprise
Performance Life Cycle (EPLC). Offerors should refer to http://www.hhs.gov/ocio/eplc
for further information related to those requirements. Offerors also should refer to CMS
Certification guidelines, updated March 31, 2016, at
https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-
systems/mect.html.
As noted in the RFP, as part of the HSD commitment to maximizing the benefits of a
modular MMISR solution, each Offeror may win no more than two MMISR
procurements and the selected IP Contractor cannot win the DS procurement.
d. SUBCONTRACTORS
While the use of subcontractors is acceptable with prior approval by HSD, the State is
seeking an IP Contractor who will perform the majority of required work, and who thus
will be directly accountable for the quality of the technology solutions, as well as for the
associated services delivered throughout the contract life. The IP Contractor is solely
responsible for performance under the contract resulting from this IP RFP. All work,
including any work performed by subcontractors, must be performed onshore. No
offshoring of work is permitted by either the prime IP Vendor or its subcontractors.
2. IP TECHNOLOGY REQUIREMENTS
a. THE IP SOLUTION
The IP solution forms the technology core for the HHS 2020 enterprise framework and
for the MMISR solution. The IP solution is the heart of an extensible and relatively fluid
solution framework that relies upon both service- and technology-based components to
enable sustainable and affordable support to HSD programs and customers.
HSD envisions the IP solution as a SOA-based platform that will enable the Department
and its partners to be more agile and flexible by providing connectivity and universal
data transformation among disparate applications, systems and services regardless of
platform, data formats or vendor. Additionally, the IP solution is intended to create and
support a system of applications and services bound together in unified workflows and
processes to meet business needs – and to be more readily changeable or changed out to
meet business requirements as they evolve over time.
The IP solution will automate many types of repetitive business and IT tasks, and will
contain pre-built integration to enable quick and easy connection to commercial-off-the-
shelf (COTS) products, cloud solutions, and BPO services. HSD is moving away from
requiring custom integration and programming to connecting disparate applications and
systems. The IP solution must use standard transaction formats, such as the Health
Insurance Portability and Accountability Act (HIPAA) Version 5010 electronic
transactions. Similarly, HSD envisions the use of an evolving set of web services,
delivered through the SOA framework, to meet a wide variety of needs.
At a minimum, the IP solution will provide four essential services for the HHS 2020
framework (Figure 3):
Monitoring, management and platform administration;
Security management;
Integration services; and
Automation and orchestration.
Figure 1 IP Solution Essential Services
b. IP TOOLS
The IP solution will provide tools for IT administrators to monitor MMISR solution
performance against required targets. Security management will ensure appropriate
authentication and authorization of integration services among applications, systems and
services, and also will control user (e.g., client, provider, MMISR contractor) access to
the MMISR solution as a whole. IP solution security management will integrate with
HSD’s Microsoft Active Directory environment for internal user access. Integration
services will enable end-to-end communication across all applications, systems and
services within in the HHS 2020 framework using application program interfaces (APIs),
third-party adapters, standard web services and secure (server to server) file transfer
formats. Automation and orchestration services will handle all message creation,
transformation, routing, validation, and translation. This service will ensure messages are
reliably transported and received among applications, systems and services.
HSD will gradually replace legacy systems as required to support changing business
needs. The IP Contractor will assist the migration to new technology solutions – and
service-based solutions – by enabling integration of legacy and new systems. The IP
solution must be “future proof” and be ready to adapt to a constantly changing IT and
business environment.
c. REUSE
NM has made significant investments in technology to support service delivery and
program management. Too often, these investments result in stand-alone solutions with
minimal shared services or infrastructure. The CMS Seven Conditions and Standards
(SCS) require states to consider reuse when planning and implementing MMIS
replacement solutions. Although SCS language emphasizes sharing across states, NM
also is applying this internally to the existing assets that support HSD program delivery.
HSD’s investments in technology assets include virtualized servers, storage area network
(SAN) devices, Exadata Oracle database devices, COTS software, and a variety of tools
to support the system life cycle. HSD seeks to reduce architectural complexity by
limiting our technology stack, where appropriate, to a small set of best-of-class solutions
and tools that are expandable, maintainable and for which a talented pool of local staff
exist.
With that in mind, Offerors are encouraged (but are not required) to propose an IP
architecture that reuses existing technology assets to the extent that this can be done
without sacrificing architectural integrity, maintainability, interoperability, scalability or
flexibility; and without creating undue complexity that isn’t commensurate with a
tradeoff in cost.
Table 8 lists assets that may be reused for the IP. VENDOR PRODUCT PURPOSE VERSION comments
Corticon Corticon Business rules engine 5.3.4.6 Planned for upgrade to 5.5
Hewlett
Packard
Exstream Notices Generation 2.3.2
IBM Websphere Application Server 8.0.0.10 Planned for upgrade to
8.5. Additional licenses
may be required
depending on
requirements
Informatica Informatica Identity
Resolution
MCI Clearance 9.2 Additional licenses may
be required depending on
requirements
Informatica PowerCenter ETL 9.6.1
SMA Opcon Batch management 5.1
Oracle Oracle Database
Edition
RDBMS 11g
(11.2.0.4)
Perceptive Image Now Enterprise document
management
7.1
SAP Data Services Address validation 4 Planned for upgrade to 4.2
IBM Clearquest Defect tracking 8.0.0.05 Additional licenses may
be required depending on
requirements
IBM Clearcase Version control 8.0.0.05
Genuitec MyEclipse Development IDE 10.7 Additional licenses may
be required depending on
requirements
CA Erwin Data modeling software 9.64
Hewlett
Packard
UFT Testing tools 12.51
Hewlett
Packard
Loadrunner Performance testing 12.01
Author-IT Author-IT On-line help development
software
5.5
Adobe Captivate eLearning content 9
CA Nimsoft Infrastructure monitoring 8.4
Nessus Security Center Security scanning 5.1
Symantec Scan Engine Anti-Virus 7
Splunk Splunk Core Log Analytics 6.2.5 Additional licenses may
be required depending on
requirements
Vormetric Vormetric Encryption at rest 5.1 Additional licenses may
be required depending on
requirements
Microsoft Active Directory Domain Controller 2008
VMware vSphere Virtualization platform 5.5
VMware View Desktop virtualization 4.x will be upgrading to
version 5.x
Red Hat Linux Operating System 6.11
Microsoft Windows Operating System 2008 R2
Symantec NetBackup Backup software 7.7.2
EMC Recover Point Storage Replication 4,5 Additional licenses may
be required depending on
requirements
VCE vBlock Virtualization Infrastructure 320GX Additional hardware may
be required depending on
requirements
Oracle Exadata Database Infrastructure X5-2
Simplivity OmniCubes Virtualization hosts CN3000 could be expanded by
adding more units
CISCO ASA 5585 Firewall 9.1
F5 BIG IP 6900 Load Balancers 11.3
EMC Data Domain Backup Storage 5.4 Additional hardware may
be required depending on
requirements
Table 1 Current HSD assets
d. CORE TECHNOLOGY
This subsection identifies technologies comprising the IP solution core infrastructure.
As noted earlier, Offerors should propose an architecture that reflects an
understanding of HSD’s HHS 2020 vision and of MMISR and IP solution
requirements, but that also reflects Offeror’s best recommendation regarding an
efficient and sustainable approach to implementing that vision. HSD is seeking an IP
solution that incorporates virtualization and real-time failover. Offerors are
encouraged to propose COTS products, open source and to adopt proven industry
best practices throughout their proposed solution.
This subsection is organized around the major HHS 2020 framework components.
e. Infrastructure
The IP solution is intended to provide the host infrastructure, and to organize and
manage the structure and visibility of data and applications required to support the
MMISR solution and the HHS 2020 enterprise. Offerors shall propose all required
hardware, software, telecommunications or other infrastructure required to implement
the IP, with emphasis on leveraging HSD’s existing investments in infrastructure,
resilience, scalability and security. (See also APPENDIX G, Section III, D.
HOSTING.)
The Contractor also shall provide all necessary infrastructure, software and tools to
support, in case of disaster, full recovery to the production IP solution at HSD’s non-
production site.
f. Service Access Layer
HSD envisions IP solution service access layer built upon an Enterprise Service Bus
(ESB) within a SOA-enabling technology solution. The IP solution must:
a. Manage, monitor and control routing, integrity and security of message
exchanges;
b. Resolve contention between communicating service components, e.g.,
1) Control deployment and versioning of services, and the use of redundant
services;
2) Develop and manage common services, such as event handling, data
transformation and mapping, and message and event queuing and
sequencing;
3) Handle security;
4) Provide structured exception and error handling;
5) Provide protocol conversion;
6) Enforce communication service quality;
c. Secure and ensure the integrity of State information;
d. Use Single Sign-on (SSO) and Identity and Access Management (IdAM) to
establish, integrate and manage unique logon IDs and security profiles for
State-authorized users, including other contractors seeking access to the
MMISR solution;
1) Use the HSD Active Directory for State employees; and
2) Use IdAM for all other users;
f. Allow access to services for data sharing between applications and entities;
g. Provide for successful integration of APIs;
h. Support automated and integrated service checkpoints to monitor service
accuracy and completeness before proceeding to the next step or application
batch process;
i. Design and maintain a suite of web services to enable processing across the
HHS 2020 framework, access to data, effective MMISR solution management
and other functions as agreed-upon with HSD;
j. Identify and use standards, protocols and methodologies to develop, maintain
and execute privacy and security audit processes, procedures, and audit trail
information and restrict access when anomalies are detected;
k. Provide the ability to suspend processing of erroneous transactions until the
error is resolved;
l. Monitor usage and maintain a record of resource levels and consumption;
m. Provide a central log of all problems and errors that includes error statistics by
module, transaction, and source;
n. Distinguish between errors (stop process) and exception (skip transaction and
continue process) conditions;
o. Perform SOA-related business process and service management;
p. Capture performance data (e.g., elapsed time, dates) to support continuous
improvement; and
q. Support “mashup” where the web server consumes several web services from
different machines and compiles content into a single user interface.
Refer to the MMISR Bidders Library for a summary of known web services required
for the MMISR solution. Offerors should assume an additional thirty (30) as-yet-
unknown services will be required, following requirements sessions.
Table 9 below lists types of services that the ESB must perform for the MMISR
solution and for the HHS 2020 framework (as well as related services from the
preceding list).
OPERATIONS and MANAGEMENT
Statistics and status error tracking
Logging and reporting
Alerting
Service level agreement (SLA) rules
Service usage tracking for chargeback/showback
Message tracking
Message throttling
Message re-delivery
Error tracking
Endpoint failover
Load balancing
High availability
Traceability
SECURITY
Authentication
Authorization
Encryption
Identity proofing
Single sign on (SSO)
Rights management
MEDIATION
Message transformation and protocol translation
Message routing
Message validation caching
Message re-sequencing
Reliable messaging
Pass-through messaging
Protocol translation
Caching
Service callout
Service composition
SERVICE HOSTING
Service containers
Component model
Service registry
ADAPTERS AND TRANSPORT
SOAP
HTT/HTTPS/REST
JMS
EJF
FTP/SFTP/SSH
Database adapters
Custom adapters
Third-party adapters
Table 2 IP solution service access layer
1. Interfaces
The IP solution provides the framework for all internal and external interfaces
required for the MMISR solution. Refer to the MMISR Bidders Library for a
summary of interfaces required for the MMISR solution. Offerors shall propose
an IP architecture that can efficiently and accurately handle these interfaces –
including initial set-up, testing, modifications, and additions. Offerors should
propose an architecture and approach that uses flexible interface standards, to
enable interfaces and data extracts with other applications and products.
2. Enterprise Technology Service Components
This subsection identifies IP solution enterprise technology service components –
software or services required to support the Medicaid enterprise and the HHS
2020 framework.
a. Extract, Transform and Load (ETL) tool – to load data into the operational
data store (ODS) and also into the Enterprise Data structure (e.g., EDW).
b. Electronic Data Interchange (EDI) tool – to handle exchange of approved EDI
transactions. HSD expects the MMISR solution to use the following X.12
transaction sets (see https://www.cms.gov/Regulations-and-
Guidance/HIPAA-Administrative-Simplification/TransactionCodeSetsStands/
TransactionsandCodeSetsRegulations.html):
1) Eligibility Benefit Inquiry and Response (Set ID 270, 271);
2) Claim Status Request and Response (Set ID 276, 277);
3) Prior Authorization Review Request and Response (Set ID 278);
4) Managed Care Organization (MCO) Capitation Payment (Set ID 820);
MCO Enrollment and Maintenance (Set ID 834);
5) Claim Payment/Advice (Set ID 835);
6) Professional Claim (Set ID 837P);
7) Institutional Claim (Set ID 837I); and
8) Dental Claim (Set ID 837D).
c. Master Index – an index designed to verify identity of one or more categories
of entity across the MMISR solution and HHS 2020 framework. HSD
requires a master index design to address:
1) Master Client Index (MCI) –compare client records from disparate
systems including federal verification and commercial data sources and
link them to create a master demographic record, containing the most
current data from all matched systems, for each citizen receiving State
services and creating a unique identifier for each individual;
2) Master Provider Index (MPI) – match source records and identifiers from
disparate systems to create a master provider record containing the most
current data from all matched systems for each provider participating in
the HSD programs and those of partner agencies, create a unique identifier
for each provider, and maintain relationships between providers, groups
and practice locations;
3) Master Agency Index (MAI) – match source records and identifiers from
disparate systems to create an master agency record to reliably indicate
which HHS 2020 participating agency provided, requested or received
data from the IP, with each participating agency to have a unique
identifier.
4) Master Employer Index (MEI) – match source records and identifiers
from disparate systems to create a master employer record containing the
most current data from all matched systems for each employer, and create
a unique identifier for employer. (There is a possibility that this will be
handled through an agreement with NM Department of Workforce
Solutions.)
HSD expects the master index(es) to:
1) Provide a sophisticated matching function to locate records, to prevent
creation of duplicate records, to provide a configurable method for
resolving near matches, and to allow the State to manually or
automatically link or unlink an individual or entity within an identified
index;
2) Improve data quality by identifying and correcting data inconsistencies
between systems and data duplication within systems;
3) Support ongoing control of data through established data governance
practices that store and maintain items in a consistent fashion and format
across all systems; and
4) Enable sharing of data throughout state government by storing essential
demographic information in a common repository.
IP Vendor will be responsible for creating and enforcing standards, protocols,
web service definition language (WSDL) and governance for all consumers of the
indexes. This procurement does not include scope to modify any of the
consuming systems.
3. Database
The IP solution encompasses three principal database/database-related
requirements:
a. Operational Data Store (ODS)
HSD expects the ODS to support both IP solution and MMISR solution
operations, as well as to be the master data repository for Medicaid-related
data and for other programmatic data that may be needed in the HHS 2020
framework over time. The ODS is intended also to be a direct source of data
for the DS solution (e.g., EDW). The ODS must provide a secure data
repository during migration from the monolithic, legacy MMIS to the
multiple-module MMISR solution, ensuring that HSD does not lose any
required data as migration occurs. The Contractor will, through the
requirements process, work with HSD to determine which data must be
retained in the ODS to support operations; HSD does not expect all Medicaid-
related data (or other programmatic data) to reside in the ODS.
The IP Contractor will procure all hardware and software needed to
implement, maintain and operate the ODS; configure the infrastructure;
design and develop the ODS; perform data conversion and load the ODS prior
to go-live for the IP; and maintain the ODS through the contract life. Offerors
should propose a data architecture to support the requirements listed
immediately below:
The ODS must, at a minimum:
1) Have sufficient capacity to support known workload requirements and be
readily expandable to accommodate increasing or changing workloads;
2) Be maintained through processes and tools that cleanse and organize data
before it is stored, and that maintain the data integrity once in the ODS,
including referential integrity and foreign key constraints on all reference
tables;
3) Support the intake and sharing of quality, secured data through MMISR
and other HHS 2020 interfaces of all types;
4) Comply with all business and regulatory requirements;
5) Support transaction handling and auditing for the MMISR solution (and
ultimately for HHS 2020);
6) Have the ability to interact with a wide range of data structures, and to
ensure that any data transmitted into the IP solution ODS maintains the
appropriate metadata necessary for identification of the original system
and data format;
7) Support data replication and synchronization across multiple servers and
provide automatic replication of table updates to multiple databases;
8) Include a metadata registry solution that provides descriptions of data
structures, formats and definitions;
9) Provide for data consolidation, federation, and sharing among enterprise
partners;
10) Use effective-dated transactions and table updates, either future dated or
retroactive, with the ability to specify data edits by transaction type;
11) Provide a service that automatically reconciles all imported and exported
data, and that provides automatic program checks to verify correct
processing and data integrity;
12) Support physical-to-logical model mapping and rationalization, and
provide ability to define model-to-model relationships among repository
objects, data models and data flows via graphical, attribute-level mapping;
13) Extend and share metadata bi-directionally with other tools and through
automated synchronization of metadata across multiple instances of the
tools;
14) Support multiple environments required for IP solution and for the
MMISR solution (e.g., development, test, production);
15) Enable role-based security, security to the attribute level of the database,
audit trails, and safe storage and handling of data in accordance with all
applicable security requirements; and
16) Minimize the need for translators and interface entities.
b. Data Warehouse Infrastructure
The IP Module r Contractor will have responsibility for the planning, design,
implementation, operation and maintenance of an EDW that will be the
master repository for reporting, ad hoc queries and analytics for the MMISR
solution and for HHS 2020. While the Data Services Module Contractor will
identify and provide the specific tools, techniques and approaches used to
deliver these services, HSD wants to ensure that the core infrastructure
supporting DS is consistent with and is hosted by the IP Contractor.
c. Master Data Management
The IP Contractor also will provide the metadata management and Master Data Management
(MDM) tools and disciplines required for the MMISR project. This includes a requirement
for the MDM solution to maintain and support the HHS 2020 logical data model (LDM),
including but not limited to associated standards, entities, relationships, definitions, domains,
keys and entity-relationship diagrams (ERDs).
To:
APPENDIX G - NM HHS 2020 - INTEGRATION PLATFORM
DETAILED STATEMENT OF WORK
This APPENDIX contains the Statement of Work. The Statement of Work is a
companion document to the requirements found in APPENDIX H, and should be read
and interpreted as a statement of both expectation and explanation of requirements
found in APPENDIX H.
1. IP CONTRACTOR ROLE
a. KEY ROLE
The IP Contractor is central to successful MMISR implementation and operation. The IP
Contractor will have a dual role:
Design, implement, maintain and operate the IP solution, which includes the ESB,
enterprise technology service components, tools, the production database(s), data
warehouse and ODS, and infrastructure to support enterprise data and interfaces; and
Work with the State to lead and coordinate the planning, management and successful
integration of the remaining MMISR vendor modules and components.
b. IP SOLUTION AND APPROACH
HSD is seeking a solution and a service-delivery approach that:
Effectively addresses the HHS 2020 vision and the chosen approach to MMISR,
while identifying risks or trade-offs and making informed recommendations for an
approach that blends the “best” use of technology and related processes, with cost-
effective implementation, maintenance and operation – including consideration of
sustainability, flexibility, maximized reuse and interoperability;
Demonstrates experience with the technologies, challenges, compliance
requirements, and opportunities associated with the recommended solution and
service-delivery approach;
Demonstrates a well-established understanding and application of proven
management, system engineering, testing, training and other applicable processes;
Credibly explains how the resources (including any subcontractors) will effectively
work as a single team to meet State requirements;
Explains how the IP solution, and the associated integration of the subsequent
MMISR vendor modules, will be planned and executed to enable successful
completion within a very aggressive time frame; and
Explains how the Contractor will manage interactions with HSD, with disparate state
and federal stakeholders, and with other involved vendors to deliver and operate an
MMISR solution comprising multiple modules.
c. COMPLETE SOLUTION
Offerors are responsible for proposing a complete Integrated Platform solution, including
all components of the IP architecture necessary to handle capacity and performance
requirements throughout the contract life, and an approach to delivering all services
required to complete all life cycle phases and responsibilities related to the IP contract.
Offerors should propose an IP architectural solution that is geared to the intent of the
HHS 2020 framework (see APPENDIX G, Section III). Offerors may propose alternative
technologies to those listed, but should explain how these serve HSD requirements and
why they are advantageous to HSD.
Offerors must propose an approach to implement and operate the IP solution that will
also use the IP solution to enable a functional MMISR solution across all involved
modules and contractors. While NOT responsible for the work of other MMISR module
contractors, the IP Contractor will be responsible for setting standards that apply across
the whole MMISR solution; for facilitating problem diagnosis and resolution across the
integrated solution; and for providing guidance, review, testing, coordination and
troubleshooting as additional MMISR contracts are awarded and modules are
implemented.
A key deliverable under this contract is an MMISR Migration Plan documenting the
approach that will be taken to migrate from the legacy MMIS to the new, multiple-
module, multiple-contractor MMISR solution on a very tight timeline. Offerors should
describe how this plan will be developed, how risks associated with the migration will be
mitigated or minimized, how continuity of operations (COO) will be maintained, how
legacy system data will be tested and validated, and the factors that will determine the
proposed sequencing, migration processes, timelines, and responsibilities that must be
incorporated in this plan.
Offerors should frame their IP solution and approach in context of the HHS 2020 vision,
of HSD’s goal of obtaining Medicaid Information Technology Architecture (MITA)
maturity level 4, and of the CMS Seven Conditions and Standards (SCS). HSD may, as
planning evolves, request the Contractor to extend support to the CSESR project, or to
other HHS 2020 initiatives, in the future to the extent that these initiatives align with and
benefit from the HHS 2020 framework.
The IP Contractor will be responsible for supporting HSD through the CMS MMIS
certification process, ensuring that the IP solution meets certification requirements, that
each subsequent module will address those requirements, and that the MMISR solution
as a whole can be certified. The MMISR project will follow the CMS Enterprise
Performance Life Cycle (EPLC). Offerors should refer to http://www.hhs.gov/ocio/eplc
for further information related to those requirements. Offerors also should refer to CMS
Certification guidelines, updated March 31, 2016, at
https://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-
systems/mect.html.
As noted in the RFP, as part of the HSD commitment to maximizing the benefits of a
modular MMISR solution, each Offeror may win no more than two MMISR
procurements and the selected IP Contractor cannot win the DS procurement.
d. SUBCONTRACTORS
While the use of subcontractors is acceptable with prior approval by HSD, the State is
seeking an IP Contractor who will perform the majority of required work, and who thus
will be directly accountable for the quality of the technology solutions, as well as for the
associated services delivered throughout the contract life. The IP Contractor is solely
responsible for performance under the contract resulting from this IP RFP. All work,
including any work performed by subcontractors, must be performed onshore. No
offshoring of work is permitted by either the prime IP Vendor or its subcontractors.
2. IP TECHNOLOGY REQUIREMENTS
a. THE IP SOLUTION
The IP solution forms the technology core for the HHS 2020 enterprise framework and
for the MMISR solution. The IP solution is the heart of an extensible and relatively fluid
solution framework that relies upon both service- and technology-based components to
enable sustainable and affordable support to HSD programs and customers.
HSD envisions the IP solution as a SOA-based platform that will enable the Department
and its partners to be more agile and flexible by providing connectivity and universal
data transformation among disparate applications, systems and services regardless of
platform, data formats or vendor. Additionally, the IP solution is intended to create and
support a system of applications and services bound together in unified workflows and
processes to meet business needs – and to be more readily changeable or changed out to
meet business requirements as they evolve over time.
The IP solution will automate many types of repetitive business and IT tasks, and will
contain pre-built integration to enable quick and easy connection to commercial-off-the-
shelf (COTS) products, cloud solutions, and BPO services. HSD is moving away from
requiring custom integration and programming to connecting disparate applications and
systems. The IP solution must use standard transaction formats, such as the Health
Insurance Portability and Accountability Act (HIPAA) Version 5010 electronic
transactions. Similarly, HSD envisions the use of an evolving set of web services,
delivered through the SOA framework, to meet a wide variety of needs.
At a minimum, the IP solution will provide four essential services for the HHS 2020
framework (Figure 3):
Monitoring, management and platform administration;
Security management;
Integration services; and
Automation and orchestration.
Figure 2 IP Solution Essential Services
b. IP TOOLS
The IP solution will provide tools for IT administrators to monitor MMISR solution
performance against required targets. Security management will ensure appropriate
authentication and authorization of integration services among applications, systems and
services, and also will control user (e.g., client, provider, MMISR contractor) access to
the MMISR solution as a whole. IP solution security management will integrate with
HSD’s Microsoft Active Directory environment for internal user access. Integration
services will enable end-to-end communication across all applications, systems and
services within in the HHS 2020 framework using application program interfaces (APIs),
third-party adapters, standard web services and secure (server to server) file transfer
formats. Automation and orchestration services will handle all message creation,
transformation, routing, validation, and translation. This service will ensure messages are
reliably transported and received among applications, systems and services.
HSD will gradually replace legacy systems as required to support changing business
needs. The IP Contractor will assist the migration to new technology solutions – and
service-based solutions – by enabling integration of legacy and new systems. The IP
solution must be “future proof” and be ready to adapt to a constantly changing IT and
business environment.
c. REUSE
NM has made significant investments in technology to support service delivery and
program management. Too often, these investments result in stand-alone solutions with
minimal shared services or infrastructure. The CMS Seven Conditions and Standards
(SCS) require states to consider reuse when planning and implementing MMIS
replacement solutions. Although SCS language emphasizes sharing across states, NM
also is applying this internally to the existing assets that support HSD program delivery.
HSD’s investments in technology assets include virtualized servers, storage area network
(SAN) devices, Exadata Oracle database devices, COTS software, and a variety of tools
to support the system life cycle. HSD seeks to reduce architectural complexity by
limiting our technology stack, where appropriate, to a small set of best-of-class solutions
and tools that are expandable, maintainable and for which a talented pool of local staff
exist.
With that in mind, Offerors are encouraged (but are not required) to propose an IP
architecture that reuses existing technology assets to the extent that this can be done
without sacrificing architectural integrity, maintainability, interoperability, scalability or
flexibility; and without creating undue complexity that isn’t commensurate with a
tradeoff in cost.
Table 8 lists assets that may be reused for the IP. VENDOR PRODUCT PURPOSE VERSION comments
Corticon Corticon Business rules engine 5.3.4.6 Planned for upgrade to 5.5
Hewlett
Packard
Exstream Notices Generation 2.3.2
IBM Websphere Application Server 8.0.0.10 Planned for upgrade to
8.5. Additional licenses
may be required
depending on
requirements
Informatica Informatica Identity
Resolution
MCI Clearance 9.2 Additional licenses may
be required depending on
requirements
Informatica PowerCenter ETL 9.6.1
SMA Opcon Batch management 5.1
Oracle Oracle Database
Edition
RDBMS 11g
(11.2.0.4)
Perceptive Image Now Enterprise document
management
7.1
SAP Data Services Address validation 4 Planned for upgrade to 4.2
IBM Clearquest Defect tracking 8.0.0.05 Additional licenses may
be required depending on
requirements
IBM Clearcase Version control 8.0.0.05
Genuitec MyEclipse Development IDE 10.7 Additional licenses may
be required depending on
requirements
CA Erwin Data modeling software 9.64
Hewlett
Packard
UFT Testing tools 12.51
Hewlett
Packard
Loadrunner Performance testing 12.01
Author-IT Author-IT On-line help development
software
5.5
Adobe Captivate eLearning content 9
CA Nimsoft Infrastructure monitoring 8.4
Nessus Security Center Security scanning 5.1
Symantec Scan Engine Anti-Virus 7
Splunk Splunk Core Log Analytics 6.2.5 Additional licenses may
be required depending on
requirements
Vormetric Vormetric Encryption at rest 5.1 Additional licenses may
be required depending on
requirements
Microsoft Active Directory Domain Controller 2008
VMware vSphere Virtualization platform 5.5
VMware View Desktop virtualization 4.x will be upgrading to
version 5.x
Red Hat Linux Operating System 6.11
Microsoft Windows Operating System 2008 R2
Symantec NetBackup Backup software 7.7.2
EMC Recover Point Storage Replication 4,5 Additional licenses may
be required depending on
requirements
VCE vBlock Virtualization Infrastructure 320GX Additional hardware may
be required depending on
requirements
Oracle Exadata Database Infrastructure X5-2
Simplivity OmniCubes Virtualization hosts CN3000 could be expanded by
adding more units
CISCO ASA 5585 Firewall 9.1
F5 BIG IP 6900 Load Balancers 11.3
EMC Data Domain Backup Storage 5.4 Additional hardware may
be required depending on
requirements
Table 3 Current HSD assets
d. CORE TECHNOLOGY
This subsection identifies technologies comprising the IP solution core infrastructure.
As noted earlier, Offerors should propose an architecture that reflects an
understanding of HSD’s HHS 2020 vision and of MMISR and IP solution
requirements, but that also reflects Offeror’s best recommendation regarding an
efficient and sustainable approach to implementing that vision. HSD is seeking an IP
solution that incorporates virtualization and real-time failover. Offerors are
encouraged to propose COTS products, open source and to adopt proven industry
best practices throughout their proposed solution.
This subsection is organized around the major HHS 2020 framework components.
e. Infrastructure
The IP solution is intended to provide the host infrastructure, and to organize and
manage the structure and visibility of data and applications required to support the
MMISR solution and the HHS 2020 enterprise. Offerors shall propose all required
hardware, software, telecommunications or other infrastructure required to implement
the IP, with emphasis on leveraging HSD’s existing investments in infrastructure,
resilience, scalability and security. (See also APPENDIX G, Section III, D.
HOSTING.)
The Contractor also shall provide all necessary infrastructure, software and tools to
support, in case of disaster, full recovery to the production IP solution at HSD’s non-
production site.
f. Service Access Layer
HSD envisions IP solution service access layer built upon an Enterprise Service Bus
(ESB) within a SOA-enabling technology solution. The IP solution must:
a. Manage, monitor and control routing, integrity and security of message
exchanges;
b. Resolve contention between communicating service components, e.g.,
1) Control deployment and versioning of services, and the use of redundant
services;
2) Develop and manage common services, such as event handling, data
transformation and mapping, and message and event queuing and
sequencing;
3) Handle security;
4) Provide structured exception and error handling;
5) Provide protocol conversion;
6) Enforce communication service quality;
c. Secure and ensure the integrity of State information;
d. Use Single Sign-on (SSO) and Identity and Access Management (IdAM) to
establish, integrate and manage unique logon IDs and security profiles for
State-authorized users, including other contractors seeking access to the
MMISR solution;
1) Use the HSD Active Directory for State employees; and
2) Use IdAM for all other users;
f. Allow access to services for data sharing between applications and entities;
g. Provide for successful integration of APIs;
h. Support automated and integrated service checkpoints to monitor service
accuracy and completeness before proceeding to the next step or application
batch process;
i. Design and maintain a suite of web services to enable processing across the
HHS 2020 framework, access to data, effective MMISR solution management
and other functions as agreed-upon with HSD;
j. Identify and use standards, protocols and methodologies to develop, maintain
and execute privacy and security audit processes, procedures, and audit trail
information and restrict access when anomalies are detected;
k. Provide the ability to suspend processing of erroneous transactions until the
error is resolved;
l. Monitor usage and maintain a record of resource levels and consumption;
m. Provide a central log of all problems and errors that includes error statistics by
module, transaction, and source;
n. Distinguish between errors (stop process) and exception (skip transaction and
continue process) conditions;
o. Perform SOA-related business process and service management;
p. Capture performance data (e.g., elapsed time, dates) to support continuous
improvement; and
q. Support “mashup” where the web server consumes several web services from
different machines and compiles content into a single user interface.
Refer to the MMISR Bidders Library for a summary of known web services required
for the MMISR solution. Offerors should assume an additional thirty (30) as-yet-
unknown services will be required, following requirements sessions.
Table 9 below lists types of services that the ESB must perform for the MMISR
solution and for the HHS 2020 framework (as well as related services from the
preceding list).
OPERATIONS and MANAGEMENT
Statistics and status error tracking
Logging and reporting
Alerting
Service level agreement (SLA) rules
Service usage tracking for chargeback/showback
Message tracking
Message throttling
Message re-delivery
Error tracking
Endpoint failover
Load balancing
High availability
Traceability
SECURITY
Authentication
Authorization
Encryption
Identity proofing
Single sign on (SSO)
Rights management
MEDIATION
Message transformation and protocol translation
Message routing
Message validation caching
Message re-sequencing
Reliable messaging
Pass-through messaging
Protocol translation
Caching
Service callout
Service composition
SERVICE HOSTING
Service containers
Component model
Service registry
ADAPTERS AND TRANSPORT
SOAP
HTT/HTTPS/REST
JMS
EJF
FTP/SFTP/SSH
Database adapters
Custom adapters
Third-party adapters
Table 4 IP solution service access layer
1. Interfaces
The IP solution provides the framework for all internal and external interfaces
required for the MMISR solution. Refer to the MMISR Bidders Library for a
summary of interfaces required for the MMISR solution. Offerors shall propose
an IP architecture that can efficiently and accurately handle these interfaces –
including initial set-up, testing, modifications, and additions. Offerors should
propose an architecture and approach that uses flexible interface standards, to
enable interfaces and data extracts with other applications and products.
2. Enterprise Technology Service Components
This subsection identifies IP solution enterprise technology service components –
software or services required to support the Medicaid enterprise and the HHS
2020 framework.
a. Extract, Transform and Load (ETL) tool – to load data into the operational
data store (ODS) and also into the Enterprise Data structure (e.g., EDW).
b. Electronic Data Interchange (EDI) tool – to handle exchange of approved EDI
transactions. HSD expects the MMISR solution to use the following X.12
transaction sets (see https://www.cms.gov/Regulations-and-
Guidance/HIPAA-Administrative-Simplification/TransactionCodeSetsStands/
TransactionsandCodeSetsRegulations.html):
1) Eligibility Benefit Inquiry and Response (Set ID 270, 271);
2) Claim Status Request and Response (Set ID 276, 277);
3) Prior Authorization Review Request and Response (Set ID 278);
4) Managed Care Organization (MCO) Capitation Payment (Set ID 820);
MCO Enrollment and Maintenance (Set ID 834);
5) Claim Payment/Advice (Set ID 835);
6) Professional Claim (Set ID 837P);
7) Institutional Claim (Set ID 837I); and
8) Dental Claim (Set ID 837D).
c. Master Index – an index designed to verify identity of one or more categories
of entity across the MMISR solution and HHS 2020 framework. HSD
requires a master index design to address:
1) Master Client Index (MCI) –compare client records from disparate
systems including federal verification and commercial data sources and
link them to create a master demographic record, containing the most
current data from all matched systems, for each citizen receiving State
services and creating a unique identifier for each individual;
2) Master Provider Index (MPI) – match source records and identifiers from
disparate systems to create a master provider record containing the most
current data from all matched systems for each provider participating in
the HSD programs and those of partner agencies, create a unique identifier
for each provider, and maintain relationships between providers, groups
and practice locations;
3) Master Agency Index (MAI) – match source records and identifiers from
disparate systems to create an master agency record to reliably indicate
which HHS 2020 participating agency provided, requested or received
data from the IP, with each participating agency to have a unique
identifier.
4) Master Employer Index (MEI) – match source records and identifiers
from disparate systems to create a master employer record containing the
most current data from all matched systems for each employer, and create
a unique identifier for employer. (There is a possibility that this will be
handled through an agreement with NM Department of Workforce
Solutions.)
HSD expects the master index(es) to:
1) Provide a sophisticated matching function to locate records, to
prevent creation of duplicate records, to provide a configurable
method for resolving near matches, and to allow the State to
manually or automatically link or unlink an individual or entity
within an identified index;
2) Improve data quality by identifying and correcting data
inconsistencies between systems and data duplication within
systems;
3) Support ongoing control of data through established data
governance practices that store and maintain items in a consistent
fashion and format across all systems; and
4) Enable sharing of data throughout state government by storing
essential demographic information in a common repository.
IP Vendor will be responsible for creating and enforcing standards, protocols,
web service definition language (WSDL) and governance for all consumers of the
indexes. This procurement does not include scope to modify any of the
consuming systems.
3. Database
The IP solution encompasses three principal database/database-related
requirements:
a. Operational Data Store (ODS)
HSD expects the ODS to support both IP solution and MMISR solution
operations, as well as to be the master data repository for Medicaid-related
data and for other programmatic data that may be needed in the HHS 2020
framework over time. The ODS is intended also to be a direct source of data
for the DS solution. The ODS must provide a secure data repository during
migration from the monolithic, legacy MMIS to the multiple-module MMISR
solution, ensuring that HSD does not lose any required data as migration
occurs. The Contractor will, through the requirements process, work with
HSD to determine which data must be retained in the ODS to support
operations; HSD does not expect all Medicaid-related data (or other
programmatic data) to reside in the ODS.
The IP Contractor will procure all hardware and software needed to
implement, maintain and operate the ODS; configure the infrastructure;
design and develop the ODS; perform data conversion and load the ODS prior
to go-live for the IP; and maintain the ODS through the contract life. Offerors
should propose a data architecture to support the requirements listed
immediately below:
The ODS must, at a minimum:
1) Have sufficient capacity to support known workload requirements and be
readily expandable to accommodate increasing or changing workloads;
2) Be maintained through processes and tools that cleanse and organize data
before it is stored, and that maintain the data integrity once in the ODS,
including referential integrity and foreign key constraints on all reference
tables;
3) Support the intake and sharing of quality, secured data through MMISR
and other HHS 2020 interfaces of all types;
4) Comply with all business and regulatory requirements;
5) Support transaction handling and auditing for the MMISR solution (and
ultimately for HHS 2020);
6) Have the ability to interact with a wide range of data structures, and to
ensure that any data transmitted into the IP solution ODS maintains the
appropriate metadata necessary for identification of the original system
and data format;
7) Support data replication and synchronization across multiple servers and
provide automatic replication of table updates to multiple databases;
8) Include a metadata registry solution that provides descriptions of data
structures, formats and definitions;
9) Provide for data consolidation, federation, and sharing among enterprise
partners;
10) Use effective-dated transactions and table updates, either future dated or
retroactive, with the ability to specify data edits by transaction type;
11) Provide a service that automatically reconciles all imported and exported
data, and that provides automatic program checks to verify correct
processing and data integrity;
12) Support physical-to-logical model mapping and rationalization, and
provide ability to define model-to-model relationships among repository
objects, data models and data flows via graphical, attribute-level mapping;
13) Extend and share metadata bi-directionally with other tools and through
automated synchronization of metadata across multiple instances of the
tools;
14) Support multiple environments required for IP solution and for the
MMISR solution (e.g., development, test, production);
15) Enable role-based security, security to the attribute level of the database,
audit trails, and safe storage and handling of data in accordance with all
applicable security requirements; and
16) Minimize the need for translators and interface entities.
b. Data Warehouse Infrastructure
The IP Module Contractor will have responsibility for the planning, design,
implementation, operation and maintenance of an EDW that will be the
master repository for reporting, ad hoc queries and analytics for the MMISR
solution and for HHS 2020. While the Data Services Module Contractor will
identify and provide the specific tools, techniques and approaches used to
deliver these services, HSD wants to ensure that the core infrastructure
supporting DS is consistent with and is hosted by the IP Contractor.
d. Master Data Management
The IP Contractor also will provide the metadata management and Master Data Management
(MDM) tools and disciplines required for the MMISR project. This includes a requirement
for the MDM solution to maintain and support the HHS 2020 logical data model (LDM),
including but not limited to associated standards, entities, relationships, definitions, domains,
keys and entity-relationship diagrams (ERDs).
3. Change to APPENDIX G – NM HHS 2020 – INTEGRATION PLATFORM
DETAILED STATEMENT OF WORK, page 102:
Removal of reference of DS in relation to the Operational Data Store (ODS) in section b.
Operational Data Store.
From:
3. IP IMPLEMENTATION
This Section identifies work the Contractor must perform to complete planning
related to the IP; to design, develop, procure, implement and test the IP; to bring the
IP solution operational; and to ensure CMS Certification of the IP module of the
MMISR solution. The Contractor is required to perform all work necessary to achieve
these goals, regardless of whether an action or task is expressly identified in this
Section. Offerors should identify in their proposals any additional work they believe
is required to successfully implement and obtain CMS Certification for the IP.
a. IP Infrastructure Procurement and Setup
The Contractor shall procure all hardware, software or other items required to
implement the final agreed-upon IP solution.
The Contractor shall have the option to install infrastructure, as appropriate, in the
NM DoIT Simms Data Center in Santa Fe, NM, and in HSD’s non-production
data center in Albuquerque, NM, with the agreement and consent of the State.
The Contractor shall work with HSD and DoIT representatives well in advance to
fully understand all requirements related to such an installation (e.g., floor space,
security, preparations, installation services, support services, timing, change
control, safety), and shall plan and perform the installation in accordance with
these requirements.
If the decision is made by both parties to install infrastructure in the NM DoIT
Data Center, then in collaboration with HSD and DoIT, the Contractor shall
perform all work required to install all proposed software on appropriate
hardware as agreed upon with the State. The Contractor shall configure the
installed software in all environments as required to meet IP solution
requirements, and explain in detail which environments will be set up for each
component, whether any components share resources and the rationale behind the
proposed architecture and setup.
Irrespective of whether the IP infrastructure solution is hosted on State equipment
or the cloud or vendor hosted solution, the Contractor shall implement multiple
environments including, at a minimum: development, quality assurance testing
(QAT), user acceptance testing (UAT), system integration testing (SIT),
production, production patch, production support, training and performance.
Contractor’s testing must demonstrate that the infrastructure is functioning fully
and correctly, as needed to support other aspects of IP solution development,
implementation and operation.
The Contractor shall document – and shall maintain current documentation of –
the IP solution production and disaster recovery infrastructure, including the
initial installation, software configuration, and comprehensive, accurate
architecture maps and diagrams showing the fully installed solution. The
Contractor shall work with HSD technical staff throughout this process to ensure
knowledge sharing and knowledge transfer is completed sufficient to ensure
adequate HSD technical understanding of the installation.
The Contractor shall develop or update all required documentation (not
previously completed) for the following CMS EPLC phases: Planning
(Configuration Management Plan), Requirements Analysis, Design,
Development, Test, and Implementation.
b. Operational Data Store
The Contractor shall perform all work required to plan, design, create, manage,
maintain, monitor, back up and patch an operational data store (ODS) to support
the IP solution, the MMISR solution as a whole and HHS 2020. At a minimum,
the Contractor shall perform the following tasks related to the ODS:
a. Assess current and future data needs to determine ODS capacity requirements,
both immediate and projected over the contract life, and project an expansion
timeline based upon these requirements;
b. Develop, document and implement (working in collaboration with the HHS
2020 PMO staff and the legacy MMIS contractor – Xerox Corporation) a
comprehensive Data Conversion Plan to address data cleanup and conversion
of data from the legacy MMIS to the IP ODS;
c. Create ETL processes to successfully import legacy data from the existing
Omnicaid databases into the ODS as needed for continuity of service and to
support the planned migration from the legacy MMIS to the MMISR solution;
1) Xerox will be responsible for: (1) extracting to comma-delimited files all
required data for the IP ODS and for the data warehouse (or other
structures) based upon business requirements; (2) cleansing all extracted
data; (3) filling the extract file with agreed-upon default data is no data is
available for a particular new field or table; (4) preparing reports for user
data clean-up from the current MMIS during dry run extract and load
processes; and (5) working with the IP Contractor and with HSD to
understand data currently in the MMIS and how it will fit into new data
tables, and to assist with mapping existing values to new meanings and/or
values.
2) The IP Contractor will: (1) work with Xerox to understand data meaning
and mapping to load data correctly to new tables; (2) transform comma-
delimited files into new values, including creating new values as needed
from legacy data that may not currently exist; (3) ensure data integrity
during loads, using referential integrity and foreign keys; (4) load database
tables and fields in the ODS (and in the EDW or other DS structures); (5)
create exception reports from dry run loads to inform Xerox and HSD of
inaccurate data that cannot be loaded; and (6) create validation reports to
confirm all data was loaded for final conversion runs.
d. Create ETL processes to initially load and then update the MMISR data
warehouse or other structure designed by the DS Contractor;
e. Revise and expand the data model over time as necessary to accommodate
additional data fields to support HSD, program requirements, analytics and
other user or enterprise requirements;
f. Manage the integrated metadata repository, including defining data
relationships that support applications, supporting software version updates,
and generating reports as needed to resolve data redundancies and/or
inconsistencies;
g. Extract data and/or receive data from operational systems, and transform and
merge this data into integrated data structures;
h. Manage the ODS, including monitoring performance, security, and data
quality; reporting on data-related activities; performing data cleansing; and
managing database performance;
i. Support physical-to-logical model mapping and rationalization, and provide
the ability to define model-to-model relationships of repository objects, data
models and data flows via graphical, attribute-level mapping;
j. Ensure data integrity using integrated security controls to ensure quality
assurance functionality and to validate key identifiers to ensure accuracy of
data as it enters the ODS, including referential integrity;
k. Deliver data, as required, to the DS solution;
l. Ensure new data items are automatically included in migration paths during
software upgrades;
m. Track and report on, as required, all records included in purges; and
n. Implement MDM, including creating and maintaining full documentation of
the ODS and of all related processes, including, but not limited to: logical data
model, physical data model, data dictionary, database administration guide,
schemas, metadata, hierarchies, data standards and harmonization strategies,
data quality management (e.g., cleansing, matching, linking, merging,
duplicate detection) and database architecture.
c. Implementation Services
The Contractor shall perform all services necessary to fully implement the IP
solution and to support attainment of CMS Certification. These services include,
but are not limited to, those listed below.
a. Requirements Analysis. The Contractor shall perform work necessary to
arrive at a final set of requirements as necessary to implement the proposed IP
solution. This work shall include, but is not limited to:
1) Analyzing requirements documentation provided by the State at the time
of contract award;
2) Planning, scheduling, conducting, documenting and coordinating the
results of requirements gathering, confirmation and/or Joint Application
Design (JAD) sessions as necessary to finalize specific requirements for
the complete IP solution, including (but not limited to):
a) Design and implementation of all components identified in the
proposed architecture in response to the requirements in APPENDIX
G, Section III;
b) Capacity planning, including system sizing and expansion;
c) All inbound and outbound interfaces;
d) Connection with DoIT and HSD-provided applications (e.g., email,
antivirus, network);
e) Data conversion;
f) Performance, including workload, monitoring operational availability
and performance, and logging reports;
g) Security, including monitoring and logging reports;
h) Database back-up and recovery;
i) Disaster recovery;
j) Standards and protocols for all ESB connections for web service
interoperability among all MMISR modules, Federal Facilitated
Marketplace (FFM), HIE, and State and Federal systems;
k) Migration from the legacy MMIS to the MMISR solution (see
APPENDIX G, Section IV.E.1);
l) ESB governance; and
m) Data governance.
3) Scheduling, conducting and documenting requirements review sessions,
including updates and production of final documents;
4) Collaborating with HSD 2020 PMO staff to ensure all requirements are
captured and managed using an agreed-upon requirements management
tool and process;
5) Uploading all final documents, and supporting working documents (as
requested by HSD), to the HHS 2020 Document Library; and
6) Actively managing IP solution requirements through the contract life
using the agreed-upon requirements management tool and processes.
b. NM DoIT Certification. The IP, and MMISR solution as a whole, must be
certified by the Technology Architecture Review Committee (TARC) prior to
entering development. The Contractor shall complete all required documents
to be submitted to the TARC, will support the HHS 2020 PMO staff in
preparing presentation materials, will support the TARC presentation, will
address technical questions raised by the TARC and will work with HSD to
make adjustments, if necessary, in IP solution plans and documentation to
achieve the required certification.
The Contractor shall provide comparable support as required for the TARC
for each subsequent DoIT phase/gate review necessary for the project.
c. Design. The Contractor shall design the complete IP solution, and shall
document this in clear, accurate and concise design documents in accordance
with CMS EPLC and NM DoIT requirements. The IP System Design
Documents (SDD) must address all IP solution elements identified in this
RFP, and identified in the preceding “Requirements Analysis” subsection.
The Contractor shall plan, schedule, conduct and document review sessions
for the SDD, including for updates and production of final documents. The
Contractor shall upload all final documents, and supporting working
documents (as requested by HSD), to the HHS 2020 Document Library.
The Contractor shall ensure that any modifications to requirements that arise
through the design process are captured, coordinated, documented in updated
IP documentation as well as in the requirements management tool.
d. Programming and Configuration. The Contractor shall perform all
programming and configuration work necessary to implement all approved IP
designs. When performing this work, the Contractor shall:
1) Follow efficient, standardized coding methodologies appropriate to this
solution;
2) Follow coding and configuration checklists and standards appropriate to
this solution;
3) Conduct code and configuration walkthroughs or reviews with HSD
technical staff and with other contractors as needed or as requested; and
4) Plan, perform and document unit testing of all code or configurations.
e. Test Planning and Execution. The Contractor shall develop, document and
execute a comprehensive test strategy and plan for the IP, working in
collaboration with HSD. Work shall include, but is not limited to:
1) Documenting and obtaining HSD approval of the IP Test Plan;
2) Creating functional test scripts for full requirements traceability;
3) Generating appropriate test data (not live production data) that is
sufficiently representative of production data to enable valid testing;
4) Preparing and maintaining the test environments throughout the test
process;
5) Creating and modifying as needed automated test scripts that will provide
end-to-end coverage of base functionality to be rerun for each release to
ensure regression compatibility;
6) Scheduling and coordinating testing;
7) Performing QAT and SIT for the IP;
8) Supporting UAT for the IP (e.g., run batch jobs, advance system clocks,
run queries to provide test data);
9) Documenting test results;
10) Making all necessary fixes and completing retesting; and
11) Analyzing test results to identify trends or issues.
f. Data Conversion. The Contractor shall complete all required data clean-up
and conversion activities, in collaboration with the legacy MMIS Contractor
(Xerox) and HSD 2020 PMO staff. Prior to roll-out of the IP solution, the
Contractor shall complete an initial load of legacy MMIS data to the IP
operational data store, in accordance with the Contractor-provided Data
Conversion Plan.
g. Training. The Contractor shall develop appropriate training documentation, in
accordance with CMS EPLC requirements, for the IP solution, addressing all
components as appropriate. The Contractor shall collaborate with the HSD
2020 PMO staff to determine the specific types of training that may need to
be delivered to HSD staff, other MMISR contractor staff and others, as
appropriate. The Contractor shall support development and delivery of that
training.
The Contractor shall ensure that all appropriate IP Contractor (and
subcontractor) staff are trained on the IP solution to the level needed to
effectively perform their work throughout the contract life.
h. Disaster Recovery and Back-up. The IP, and the MMISR solution as a whole,
are mission critical systems for HSD. The IP Contractor shall develop,
document, coordinate and implement a comprehensive Contingency Plan that
addresses, at a minimum, disaster recovery, back-up and continuity of
operations. This Plan shall address all CMS, DoIT and HSD requirements.
The Contractor shall update this Plan quarterly, at a minimum, with any
changes to the IP architecture, application inventory, procedures and
processes.
The IP Contractor must perform and manage all system back-up activities in
accordance with HSD policies and requirements, including regular testing of
restore procedures and performing capacity management related to back-up
files. The IP Contractor also must plan, lead and document an annual end-to-
end disaster recovery exercise that includes failover of all components of the
IP solution.
i. Implementation. The Contractor shall perform all tasks required to roll the IP
solution into production, including, but not limited to:
1) Scheduling a release date appropriate to HSD (in collaboration with the
HHS 2020 PMO staff);
2) Create a baseline for the IP solution release using an agreed-upon
configuration control tool and process;
3) Migrate the IP solution release to production;
4) Verify the IP’s operational readiness;
5) If necessary due to partial or full failure of the IP solution rollout, execute
the planned approach to roll back and to recover operations until the IP
solution can be successfully implemented; and
6) Implement system diagnostics and tools to provide automatic system
monitoring.
j. CMS Certification. The Contractor shall create all required documentation of
the IP solution needed to support CMS Certification. (See also APPENDIX G,
Section IV.E, INTEGRATION MANAGEMENT, for additional service
requirements related to the MMISR solution as a whole.) The Contractor is
responsible for supporting CMS Certification of the IP module, and for taking
any corrective actions, completing additional document, participating in
meetings or presentations, or other work required to ensure CMS Certification
is received.
To:
3. IP IMPLEMENTATION
This Section identifies work the Contractor must perform to complete planning
related to the IP; to design, develop, procure, implement and test the IP; to bring the
IP solution operational; and to ensure CMS Certification of the IP module of the
MMISR solution. The Contractor is required to perform all work necessary to achieve
these goals, regardless of whether an action or task is expressly identified in this
Section. Offerors should identify in their proposals any additional work they believe
is required to successfully implement and obtain CMS Certification for the IP.
a. IP Infrastructure Procurement and Setup
The Contractor shall procure all hardware, software or other items required to
implement the final agreed-upon IP solution.
The Contractor shall have the option to install infrastructure, as appropriate, in the
NM DoIT Simms Data Center in Santa Fe, NM, and in HSD’s non-production
data center in Albuquerque, NM, with the agreement and consent of the State.
The Contractor shall work with HSD and DoIT representatives well in advance to
fully understand all requirements related to such an installation (e.g., floor space,
security, preparations, installation services, support services, timing, change
control, safety), and shall plan and perform the installation in accordance with
these requirements.
If the decision is made by both parties to install infrastructure in the NM DoIT
Data Center, then in collaboration with HSD and DoIT, the Contractor shall
perform all work required to install all proposed software on appropriate
hardware as agreed upon with the State. The Contractor shall configure the
installed software in all environments as required to meet IP solution
requirements, and explain in detail which environments will be set up for each
component, whether any components share resources and the rationale behind the
proposed architecture and setup.
Irrespective of whether the IP infrastructure solution is hosted on State equipment
or the cloud or vendor hosted solution, the Contractor shall implement multiple
environments including, at a minimum: development, quality assurance testing
(QAT), user acceptance testing (UAT), system integration testing (SIT),
production, production patch, production support, training and performance.
Contractor’s testing must demonstrate that the infrastructure is functioning fully
and correctly, as needed to support other aspects of IP solution development,
implementation and operation.
The Contractor shall document – and shall maintain current documentation of –
the IP solution production and disaster recovery infrastructure, including the
initial installation, software configuration, and comprehensive, accurate
architecture maps and diagrams showing the fully installed solution. The
Contractor shall work with HSD technical staff throughout this process to ensure
knowledge sharing and knowledge transfer is completed sufficient to ensure
adequate HSD technical understanding of the installation.
The Contractor shall develop or update all required documentation (not
previously completed) for the following CMS EPLC phases: Planning
(Configuration Management Plan), Requirements Analysis, Design,
Development, Test, and Implementation.
b. Operational Data Store
The Contractor shall perform all work required to plan, design, create, manage,
maintain, monitor, back up and patch an operational data store (ODS) to support
the IP solution, the MMISR solution as a whole and HHS 2020. At a minimum,
the Contractor shall perform the following tasks related to the ODS:
a. Assess current and future data needs to determine ODS capacity
requirements, both immediate and projected over the contract life, and
project an expansion timeline based upon these requirements;
b. Develop, document and implement (working in collaboration with the HHS
2020 PMO staff and the legacy MMIS contractor – Xerox Corporation) a
comprehensive Data Conversion Plan to address data cleanup and conversion
of data from the legacy MMIS to the IP ODS;
c. Create ETL processes to successfully import legacy data from the existing
Omnicaid databases into the ODS as needed for continuity of service and to
support the planned migration from the legacy MMIS to the MMISR solution;
1) Xerox will be responsible for: (1) extracting to comma-delimited files all
required data for the IP ODS and for the data warehouse (or other
structures) based upon business requirements; (2) cleansing all extracted
data; (3) filling the extract file with agreed-upon default data is no data is
available for a particular new field or table; (4) preparing reports for user
data clean-up from the current MMIS during dry run extract and load
processes; and (5) working with the IP Contractor and with HSD to
understand data currently in the MMIS and how it will fit into new data
tables, and to assist with mapping existing values to new meanings
and/or values.
2) The IP Contractor will: (1) work with Xerox to understand data meaning
and mapping to load data correctly to new tables; (2) transform comma-
delimited files into new values, including creating new values as needed
from legacy data that may not currently exist; (3) ensure data integrity
during loads, using referential integrity and foreign keys; (4) load
database tables and fields in the ODS (and in the EDW or other DS
structures); (5) create exception reports from dry run loads to inform
Xerox and HSD of inaccurate data that cannot be loaded; and (6) create
validation reports to confirm all data was loaded for final conversion
runs.
d. Create ETL processes to initially load and then update the MMISR data
warehouse or other structure designed by the DS Contractor;
e. Revise and expand the data model over time as necessary to accommodate
additional data fields to support HSD, program requirements, analytics and
other user or enterprise requirements;
f. Manage the integrated metadata repository, including defining data
relationships that support applications, supporting software version updates,
and generating reports as needed to resolve data redundancies and/or
inconsistencies;
g. Extract data and/or receive data from operational systems, and transform and
merge this data into integrated data structures;
h. Manage the ODS, including monitoring performance, security, and data
quality; reporting on data-related activities; performing data cleansing; and
managing database performance;
i. Support physical-to-logical model mapping and rationalization, and provide
the ability to define model-to-model relationships of repository objects, data
models and data flows via graphical, attribute-level mapping;
j. Ensure data integrity using integrated security controls to ensure quality
assurance functionality and to validate key identifiers to ensure accuracy of
data as it enters the ODS, including referential integrity;
k. Deliver data, as required, to the DS solution;
l. Ensure new data items are automatically included in migration paths during
software upgrades;
m. Track and report on, as required, all records included in purges; and
n. Implement MDM, including creating and maintaining full documentation of
the ODS and of all related processes, including, but not limited to: logical data
model, physical data model, data dictionary, database administration guide,
schemas, metadata, hierarchies, data standards and harmonization strategies,
data quality management (e.g., cleansing, matching, linking, merging,
duplicate detection) and database architecture.
c. Implementation Services
The Contractor shall perform all services necessary to fully implement the IP
solution and to support attainment of CMS Certification. These services include,
but are not limited to, those listed below.
a. Requirements Analysis. The Contractor shall perform work necessary to
arrive at a final set of requirements as necessary to implement the
proposed IP solution. This work shall include, but is not limited to:
1) Analyzing requirements documentation provided by the State at the time
of contract award;
2) Planning, scheduling, conducting, documenting and coordinating the
results of requirements gathering, confirmation and/or Joint Application
Design (JAD) sessions as necessary to finalize specific requirements for
the complete IP solution, including (but not limited to):
a) Design and implementation of all components identified in the
proposed architecture in response to the requirements in APPENDIX
G, Section III;
b) Capacity planning, including system sizing and expansion;
c) All inbound and outbound interfaces;
d) Connection with DoIT and HSD-provided applications (e.g., email,
antivirus, network);
e) Data conversion;
f) Performance, including workload, monitoring operational availability
and performance, and logging reports;
g) Security, including monitoring and logging reports;
h) Database back-up and recovery;
i) Disaster recovery;
j) Standards and protocols for all ESB connections for web service
interoperability among all MMISR modules, Federal Facilitated
Marketplace (FFM), HIE, and State and Federal systems;
k) Migration from the legacy MMIS to the MMISR solution (see
APPENDIX G, Section IV.E.1);
l) ESB governance; and
m) Data governance.
3) Scheduling, conducting and documenting requirements review sessions,
including updates and production of final documents;
4) Collaborating with HSD 2020 PMO staff to ensure all requirements are
captured and managed using an agreed-upon requirements management
tool and process;
5) Uploading all final documents, and supporting working documents (as
requested by HSD), to the HHS 2020 Document Library; and
6) Actively managing IP solution requirements through the contract life
using the agreed-upon requirements management tool and processes.
a. NM DoIT Certification. The IP, and MMISR solution as a whole,
must be certified by the Technology Architecture Review Committee
(TARC) prior to entering development. The Contractor shall complete
all required documents to be submitted to the TARC, will support the
HHS 2020 PMO staff in preparing presentation materials, will support
the TARC presentation, will address technical questions raised by the
TARC and will work with HSD to make adjustments, if necessary, in
IP solution plans and documentation to achieve the required
certification.
The Contractor shall provide comparable support as required for the TARC
for each subsequent DoIT phase/gate review necessary for the project.
b. Design. The Contractor shall design the complete IP solution, and
shall document this in clear, accurate and concise design documents in
accordance with CMS EPLC and NM DoIT requirements. The IP
System Design Documents (SDD) must address all IP solution
elements identified in this RFP, and identified in the preceding
“Requirements Analysis” subsection.
The Contractor shall plan, schedule, conduct and document review sessions
for the SDD, including for updates and production of final documents. The
Contractor shall upload all final documents, and supporting working
documents (as requested by HSD), to the HHS 2020 Document Library.
The Contractor shall ensure that any modifications to requirements that arise
through the design process are captured, coordinated, documented in updated
IP documentation as well as in the requirements management tool.
c. Programming and Configuration. The Contractor shall perform all
programming and configuration work necessary to implement all
approved IP designs. When performing this work, the Contractor shall:
7) Follow efficient, standardized coding methodologies appropriate to this
solution;
8) Follow coding and configuration checklists and standards appropriate to
this solution;
9) Conduct code and configuration walkthroughs or reviews with HSD
technical staff and with other contractors as needed or as requested; and
10) Plan, perform and document unit testing of all code or configurations.
a. Test Planning and Execution. The Contractor shall develop, document
and execute a comprehensive test strategy and plan for the IP, working
in collaboration with HSD. Work shall include, but is not limited to:
11) Documenting and obtaining HSD approval of the IP Test Plan;
12) Creating functional test scripts for full requirements traceability;
13) Generating appropriate test data (not live production data) that is
sufficiently representative of production data to enable valid testing;
14) Preparing and maintaining the test environments throughout the test
process;
15) Creating and modifying as needed automated test scripts that will provide
end-to-end coverage of base functionality to be rerun for each release to
ensure regression compatibility;
16) Scheduling and coordinating testing;
17) Performing QAT and SIT for the IP;
18) Supporting UAT for the IP (e.g., run batch jobs, advance system clocks,
run queries to provide test data);
19) Documenting test results;
20) Making all necessary fixes and completing retesting; and
21) Analyzing test results to identify trends or issues.
a. Data Conversion. The Contractor shall complete all required data
clean-up and conversion activities, in collaboration with the legacy
MMIS Contractor (Xerox) and HSD 2020 PMO staff. Prior to roll-out
of the IP solution, the Contractor shall complete an initial load of
legacy MMIS data to the IP operational data store, in accordance with
the Contractor-provided Data Conversion Plan.
b. Training. The Contractor shall develop appropriate training
documentation, in accordance with CMS EPLC requirements, for the
IP solution, addressing all components as appropriate. The Contractor
shall collaborate with the HSD 2020 PMO staff to determine the
specific types of training that may need to be delivered to HSD staff,
other MMISR contractor staff and others, as appropriate. The
Contractor shall support development and delivery of that training.
The Contractor shall ensure that all appropriate IP Contractor (and
subcontractor) staff are trained on the IP solution to the level needed to
effectively perform their work throughout the contract life.
a. Disaster Recovery and Back-up. The IP, and the MMISR solution as a
whole, are mission critical systems for HSD. The IP Contractor shall
develop, document, coordinate and implement a comprehensive
Contingency Plan that addresses, at a minimum, disaster recovery,
back-up and continuity of operations. This Plan shall address all
CMS, DoIT and HSD requirements. The Contractor shall update this
Plan quarterly, at a minimum, with any changes to the IP architecture,
application inventory, procedures and processes.
The IP Contractor must perform and manage all system back-up activities in
accordance with HSD policies and requirements, including regular testing of
restore procedures and performing capacity management related to back-up
files. The IP Contractor also must plan, lead and document an annual end-to-
end disaster recovery exercise that includes failover of all components of the
IP solution.
a. Implementation. The Contractor shall perform all tasks required to roll
the IP solution into production, including, but not limited to:
22) Scheduling a release date appropriate to HSD (in collaboration with the
HHS 2020 PMO staff);
23) Create a baseline for the IP solution release using an agreed-upon
configuration control tool and process;
24) Migrate the IP solution release to production;
25) Verify the IP’s operational readiness;
26) If necessary due to partial or full failure of the IP solution rollout, execute
the planned approach to roll back and to recover operations until the IP
solution can be successfully implemented; and
27) Implement system diagnostics and tools to provide automatic system
monitoring.
a. CMS Certification. The Contractor shall create all required
documentation of the IP solution needed to support CMS Certification.
(See also APPENDIX G, Section IV.E, INTEGRATION
MANAGEMENT, for additional service requirements related to the
MMISR solution as a whole.) The Contractor is responsible for
supporting CMS Certification of the IP module, and for taking any
corrective actions, completing additional document, participating in
meetings or presentations, or other work required to ensure CMS
Certification is received.
To:
4. IP IMPLEMENTATION
This Section identifies work the Contractor must perform to complete planning
related to the IP; to design, develop, procure, implement and test the IP; to bring the
IP solution operational; and to ensure CMS Certification of the IP module of the
MMISR solution. The Contractor is required to perform all work necessary to achieve
these goals, regardless of whether an action or task is expressly identified in this
Section. Offerors should identify in their proposals any additional work they believe
is required to successfully implement and obtain CMS Certification for the IP.
a. IP Infrastructure Procurement and Setup
The Contractor shall procure all hardware, software or other items required to
implement the final agreed-upon IP solution.
The Contractor shall have the option to install infrastructure, as appropriate, in the
NM DoIT Simms Data Center in Santa Fe, NM, and in HSD’s non-production
data center in Albuquerque, NM, with the agreement and consent of the State.
The Contractor shall work with HSD and DoIT representatives well in advance to
fully understand all requirements related to such an installation (e.g., floor space,
security, preparations, installation services, support services, timing, change
control, safety), and shall plan and perform the installation in accordance with
these requirements.
If the decision is made by both parties to install infrastructure in the NM DoIT
Data Center, then in collaboration with HSD and DoIT, the Contractor shall
perform all work required to install all proposed software on appropriate
hardware as agreed upon with the State. The Contractor shall configure the
installed software in all environments as required to meet IP solution
requirements, and explain in detail which environments will be set up for each
component, whether any components share resources and the rationale behind the
proposed architecture and setup.
Irrespective of whether the IP infrastructure solution is hosted on State equipment
or the cloud or vendor hosted solution, the Contractor shall implement multiple
environments including, at a minimum: development, quality assurance testing
(QAT), user acceptance testing (UAT), system integration testing (SIT),
production, production patch, production support, training and performance.
Contractor’s testing must demonstrate that the infrastructure is functioning fully
and correctly, as needed to support other aspects of IP solution development,
implementation and operation.
The Contractor shall document – and shall maintain current documentation of –
the IP solution production and disaster recovery infrastructure, including the
initial installation, software configuration, and comprehensive, accurate
architecture maps and diagrams showing the fully installed solution. The
Contractor shall work with HSD technical staff throughout this process to ensure
knowledge sharing and knowledge transfer is completed sufficient to ensure
adequate HSD technical understanding of the installation.
The Contractor shall develop or update all required documentation (not
previously completed) for the following CMS EPLC phases: Planning
(Configuration Management Plan), Requirements Analysis, Design,
Development, Test, and Implementation.
b. Operational Data Store
The Contractor shall perform all work required to plan, design, create, manage,
maintain, monitor, back up and patch an operational data store (ODS) to support
the IP solution, the MMISR solution as a whole and HHS 2020. At a minimum,
the Contractor shall perform the following tasks related to the ODS:
a. Assess current and future data needs to determine ODS capacity requirements,
both immediate and projected over the contract life, and project an expansion
timeline based upon these requirements;
b. Develop, document and implement (working in collaboration with the HHS
2020 PMO staff and the legacy MMIS contractor – Xerox Corporation) a
comprehensive Data Conversion Plan to address data cleanup and conversion
of data from the legacy MMIS to the IP ODS;
c. Create ETL processes to successfully import legacy data from the existing
Omnicaid databases into the ODS as needed for continuity of service and to
support the planned migration from the legacy MMIS to the MMISR solution;
1) Xerox will be responsible for: (1) extracting to comma-delimited files all
required data for the IP ODS and for the data warehouse (or other
structures) based upon business requirements; (2) cleansing all extracted
data; (3) filling the extract file with agreed-upon default data is no data is
available for a particular new field or table; (4) preparing reports for user
data clean-up from the current MMIS during dry run extract and load
processes; and (5) working with the IP Contractor and with HSD to
understand data currently in the MMIS and how it will fit into new data
tables, and to assist with mapping existing values to new meanings and/or
values.
2) The IP Contractor will: (1) work with Xerox to understand data meaning
and mapping to load data correctly to new tables; (2) transform comma-
delimited files into new values, including creating new values as needed
from legacy data that may not currently exist; (3) ensure data integrity
during loads, using referential integrity and foreign keys; (4) load database
tables and fields in the ODS (and in the EDW); (5) create exception
reports from dry run loads to inform Xerox and HSD of inaccurate data
that cannot be loaded; and (6) create validation reports to confirm all data
was loaded for final conversion runs.
d. Create ETL processes to initially load and then update the MMISR data
warehouse or other structure designed by the DS Contractor;
e. Revise and expand the data model over time as necessary to accommodate
additional data fields to support HSD, program requirements, analytics and
other user or enterprise requirements;
f. Manage the integrated metadata repository, including defining data
relationships that support applications, supporting software version updates,
and generating reports as needed to resolve data redundancies and/or
inconsistencies;
g. Extract data and/or receive data from operational systems, and transform and
merge this data into integrated data structures;
h. Manage the ODS, including monitoring performance, security, and data
quality; reporting on data-related activities; performing data cleansing; and
managing database performance;
i. Support physical-to-logical model mapping and rationalization, and provide
the ability to define model-to-model relationships of repository objects, data
models and data flows via graphical, attribute-level mapping;
j. Ensure data integrity using integrated security controls to ensure quality
assurance functionality and to validate key identifiers to ensure accuracy of
data as it enters the ODS, including referential integrity;
k. Deliver data, as required, to the DS solution;
l. Ensure new data items are automatically included in migration paths during
software upgrades;
m. Track and report on, as required, all records included in purges; and
n. Implement MDM, including creating and maintaining full documentation of
the ODS and of all related processes, including, but not limited to: logical data
model, physical data model, data dictionary, database administration guide,
schemas, metadata, hierarchies, data standards and harmonization strategies,
data quality management (e.g., cleansing, matching, linking, merging,
duplicate detection) and database architecture.
c. Implementation Services
The Contractor shall perform all services necessary to fully implement the IP
solution and to support attainment of CMS Certification. These services include,
but are not limited to, those listed below.
a. Requirements Analysis. The Contractor shall perform work necessary to
arrive at a final set of requirements as necessary to implement the proposed IP
solution. This work shall include, but is not limited to:
28) Analyzing requirements documentation provided by the State at the time
of contract award;
29) Planning, scheduling, conducting, documenting and coordinating the
results of requirements gathering, confirmation and/or Joint Application
Design (JAD) sessions as necessary to finalize specific requirements for
the complete IP solution, including (but not limited to):
a) Design and implementation of all components identified in the
proposed architecture in response to the requirements in APPENDIX
G, Section III;
b) Capacity planning, including system sizing and expansion;
c) All inbound and outbound interfaces;
d) Connection with DoIT and HSD-provided applications (e.g., email,
antivirus, network);
e) Data conversion;
f) Performance, including workload, monitoring operational availability
and performance, and logging reports;
g) Security, including monitoring and logging reports;
h) Database back-up and recovery;
i) Disaster recovery;
j) Standards and protocols for all ESB connections for web service
interoperability among all MMISR modules, Federal Facilitated
Marketplace (FFM), HIE, and State and Federal systems;
k) Migration from the legacy MMIS to the MMISR solution (see
APPENDIX G, Section IV.E.1);
l) ESB governance; and
m) Data governance.
30) Scheduling, conducting and documenting requirements review sessions,
including updates and production of final documents;
31) Collaborating with HSD 2020 PMO staff to ensure all requirements are
captured and managed using an agreed-upon requirements management
tool and process;
32) Uploading all final documents, and supporting working documents (as
requested by HSD), to the HHS 2020 Document Library; and
33) Actively managing IP solution requirements through the contract life
using the agreed-upon requirements management tool and processes.
b. NM DoIT Certification. The IP, and MMISR solution as a whole, must be
certified by the Technology Architecture Review Committee (TARC) prior to
entering development. The Contractor shall complete all required documents
to be submitted to the TARC, will support the HHS 2020 PMO staff in
preparing presentation materials, will support the TARC presentation, will
address technical questions raised by the TARC and will work with HSD to
make adjustments, if necessary, in IP solution plans and documentation to
achieve the required certification.
The Contractor shall provide comparable support as required for the TARC
for each subsequent DoIT phase/gate review necessary for the project.
c. Design. The Contractor shall design the complete IP solution, and shall
document this in clear, accurate and concise design documents in accordance
with CMS EPLC and NM DoIT requirements. The IP System Design
Documents (SDD) must address all IP solution elements identified in this
RFP, and identified in the preceding “Requirements Analysis” subsection.
The Contractor shall plan, schedule, conduct and document review sessions
for the SDD, including for updates and production of final documents. The
Contractor shall upload all final documents, and supporting working
documents (as requested by HSD), to the HHS 2020 Document Library.
The Contractor shall ensure that any modifications to requirements that arise
through the design process are captured, coordinated, documented in updated
IP documentation as well as in the requirements management tool.
d. Programming and Configuration. The Contractor shall perform all
programming and configuration work necessary to implement all approved IP
designs. When performing this work, the Contractor shall:
1) Follow efficient, standardized coding methodologies appropriate to this
solution;
2) Follow coding and configuration checklists and standards appropriate to
this solution;
3) Conduct code and configuration walkthroughs or reviews with HSD
technical staff and with other contractors as needed or as requested; and
4) Plan, perform and document unit testing of all code or configurations.
e. Test Planning and Execution. The Contractor shall develop, document and
execute a comprehensive test strategy and plan for the IP, working in
collaboration with HSD. Work shall include, but is not limited to:
1) Documenting and obtaining HSD approval of the IP Test Plan;
2) Creating functional test scripts for full requirements traceability;
3) Generating appropriate test data (not live production data) that is
sufficiently representative of production data to enable valid testing;
4) Preparing and maintaining the test environments throughout the test
process;
5) Creating and modifying as needed automated test scripts that will provide
end-to-end coverage of base functionality to be rerun for each release to
ensure regression compatibility;
6) Scheduling and coordinating testing;
7) Performing QAT and SIT for the IP;
8) Supporting UAT for the IP (e.g., run batch jobs, advance system clocks,
run queries to provide test data);
9) Documenting test results;
10) Making all necessary fixes and completing retesting; and
11) Analyzing test results to identify trends or issues.
f. Data Conversion. The Contractor shall complete all required data clean-up
and conversion activities, in collaboration with the legacy MMIS Contractor
(Xerox) and HSD 2020 PMO staff. Prior to roll-out of the IP solution, the
Contractor shall complete an initial load of legacy MMIS data to the IP
operational data store, in accordance with the Contractor-provided Data
Conversion Plan.
g. Training. The Contractor shall develop appropriate training documentation, in
accordance with CMS EPLC requirements, for the IP solution, addressing all
components as appropriate. The Contractor shall collaborate with the HSD
2020 PMO staff to determine the specific types of training that may need to
be delivered to HSD staff, other MMISR contractor staff and others, as
appropriate. The Contractor shall support development and delivery of that
training.
The Contractor shall ensure that all appropriate IP Contractor (and
subcontractor) staff are trained on the IP solution to the level needed to
effectively perform their work throughout the contract life.
h. Disaster Recovery and Back-up. The IP, and the MMISR solution as a whole,
are mission critical systems for HSD. The IP Contractor shall develop,
document, coordinate and implement a comprehensive Contingency Plan that
addresses, at a minimum, disaster recovery, back-up and continuity of
operations. This Plan shall address all CMS, DoIT and HSD requirements.
The Contractor shall update this Plan quarterly, at a minimum, with any
changes to the IP architecture, application inventory, procedures and
processes.
The IP Contractor must perform and manage all system back-up activities in
accordance with HSD policies and requirements, including regular testing of
restore procedures and performing capacity management related to back-up
files. The IP Contractor also must plan, lead and document an annual end-to-
end disaster recovery exercise that includes failover of all components of the
IP solution.
i. Implementation. The Contractor shall perform all tasks required to roll the IP
solution into production, including, but not limited to:
1) Scheduling a release date appropriate to HSD (in collaboration with the
HHS 2020 PMO staff);
2) Create a baseline for the IP solution release using an agreed-upon
configuration control tool and process;
3) Migrate the IP solution release to production;
4) Verify the IP’s operational readiness;
5) If necessary due to partial or full failure of the IP solution rollout, execute
the planned approach to roll back and to recover operations until the IP
solution can be successfully implemented; and
6) Implement system diagnostics and tools to provide automatic system
monitoring.
j. CMS Certification. The Contractor shall create all required documentation of
the IP solution needed to support CMS Certification. (See also APPENDIX G,
Section IV.E, INTEGRATION MANAGEMENT, for additional service
requirements related to the MMISR solution as a whole.) The Contractor is
responsible for supporting CMS Certification of the IP module, and for taking
any corrective actions, completing additional document, participating in
meetings or presentations, or other work required to ensure CMS Certification
is received.
5. Change to Section V. CONDITIONS GOVERNING THE PROCUREMENT, page
35:
Date Change for Action #6 Submission of Proposal. Change also includes new dates to
Action # 7,8,9,10,11.
From:
CONDITIONS GOVERNING THE PROCUREMENT
This section of the RFP presents the schedule, description and conditions governing the
procurement.
SEQUENCE OF EVENTS
The Procurement Manager will make every effort to adhere to the following
schedule:
Action Responsible Party Due Date
1. Issue RFP HSD August 25, 2016
2. Distribution List Confirmation HSD September 7, 2016
3. Pre-Proposal Conference HSD September 7, 2016
4. Deadline to Submit Questions Potential Offerors September 14, 2016
5. Response to Written Questions Procurement Manager September 22, 2016
6. Submission of Proposal Potential Offerors October 14, 2016
7. Proposal Evaluation Evaluation Committee October 15-24, 2016
8. Selection of Finalists Evaluation Committee October 24, 2016
9. Best and Final Offer Finalist Offerors November 1, 2016
10. Oral Presentation(s) Finalist Offerors November 8-9, 2016
11. Finalize Contractual Agreements HSD/Finalist Offerors December 5, 2016
12. Approval of Contract (Federal &
State)
CMS/DoIT February 5, 2017
13. Contracts Award HSD/Finalist Offerors February 6, 2017
14. Protest Deadline HSD 15 calendar days after
contract award notice
* Dates subject to change based on number of responses and final approval from Federal partners.
Table 5 Sequence of Events.
To:
CONDITIONS GOVERNING THE PROCUREMENT
This section of the RFP presents the schedule, description and conditions governing the
procurement.
SEQUENCE OF EVENTS
The Procurement Manager will make every effort to adhere to the following
schedule:
Action Responsible Party Due Date
1. Issue RFP HSD August 25, 2016
2. Distribution List Confirmation HSD September 7, 2016
3. Pre-Proposal Conference HSD September 7, 2016
4. Deadline to Submit Questions Potential Offerors September 14, 2016
5. Response to Written Questions Procurement Manager September 22, 2016
6. Submission of Proposal Potential Offerors October 21, 2016
7. Proposal Evaluation Evaluation Committee October 22-31, 2016
8. Selection of Finalists Evaluation Committee October 31, 2016
9. Best and Final Offer Finalist Offerors November 8, 2016
10. Oral Presentation(s) Finalist Offerors November 15-16, 2016
11. Finalize Contractual Agreements HSD/Finalist Offerors December 12, 2016
12. Approval of Contract (Federal &
State)
CMS/DoIT February 5, 2017
13. Contracts Award HSD/Finalist Offerors February 6, 2017
14. Protest Deadline HSD 15 calendar days after
contract award notice
* Dates subject to change based on number of responses and final approval from Federal partners.
Table 6 Sequence of Events.
6. Change to Section IV BACKGROUND INFORMATION –Business Objectives, page
33:
Addendum #13, 14 and 15 added.
From:
G. MMISR PROCUREMENT LIBRARY
An MMISR Procurement Library has been established and can be accessed at
https://nmhsd-public.sharepoint.com/Pages/HSDProcurementLibrary.aspx.
Offerors are encouraged to review the materials contained in the Procurement Library
by selecting the link provided in the electronic version of this document through your
own internet connection or by contacting the Procurement Manager and scheduling
an appointment. The procurement library, accessible at [link], contains the
information listed below.
The RFP is posted on the NM HSD website:
http://www.hsd.state.nm.us/LookingForInformation/open-rfps.aspx
NM Procurement regulations and RFP instructions:
http://www.generalservices.state.nm.us/statepurchasing/ITBs
RFPs_and_Bid_Tabulation.aspx.
42 CFR Part 433 (c): http://www.ecfr.gov/cgi-bin/text- idx?SID=f100ecfeaa4b4f7032c97c20d7746886&node=sp42.4.433.c&rgn=div6
45 CFR Part 95 (f): http://www.ecfr.gov/cgi-bin/text-
idx?SID=735a4beac7b39103a5c80483d3ffa209&node=sp45.1.95.f&rgn=div6
State Medicaid Manual Part 11: http://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021927.html
CMS Seven Conditions and Standards: http://www.medicaid.gov/Medicaid-CHIP-
Program-Information/By-Topics/Data-and-Systems/Downloads/EFR-Seven-
Conditions- and-Standards.pdf
CMS MMIS Certification Toolkit and Checklist: http://www.cms.gov/Research-
Statistics- Data-and-Systems/Computer-Data-and-Systems/MMIS/MECT.html
Privacy and Security Standards – NIST Special Publications:
http://csrc.nist.gov/publications/PubsSPs.html
CMS MITA: http://www.medicaid.gov/medicaid-chip-program-information/by-
topics/data- and-systems/medicaid-information-technology-architecture-mita.html
NM 2015 MITA 3.0 State Self-Assessment, on the NMHSD website: https://nmhsd-public.sharepoint.com/HSDProcurementLibrary/MAD%20MITA%20SSA%203.0.docx?d=wc57dba127139437bafef040e5aa36dc9
HIPAA and ACA: Administrative Simplification Overview https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/index.html Program-related Documents in the Library: The library contains reference documents
related to this procurement, including:
1. HHS 2020 Roles and Responsibilities
2. HHS 2020 Background Information NM HHS and Medicaid
3. HHS 2020 Work Flows
4. HHS 2020 Stakeholder Relationship Diagrams
5. HHS 2020 User Views
6. HHS 2020 Data Flows
7. HHS 2020 Acronyms
8. HHS 2020 Terms and Definitions
9. HHS 2020 Activity Data
10. HHS 2020 CMS Seven Standards and Conditions
11. HHS 2020 Overview of the NM Medicaid Program
12. HHS 2020 Legacy Interfaces
To:
G. MMISR PROCUREMENT LIBRARY
An MMISR Procurement Library has been established and can be accessed at
https://nmhsd-public.sharepoint.com/Pages/HSDProcurementLibrary.aspx.
Offerors are encouraged to review the materials contained in the Procurement Library
by selecting the link provided in the electronic version of this document through your
own internet connection or by contacting the Procurement Manager and scheduling
an appointment. The procurement library, accessible at [link], contains the
information listed below.
The RFP is posted on the NM HSD website:
http://www.hsd.state.nm.us/LookingForInformation/open-rfps.aspx
NM Procurement regulations and RFP instructions:
http://www.generalservices.state.nm.us/statepurchasing/ITBs
RFPs_and_Bid_Tabulation.aspx.
42 CFR Part 433 (c): http://www.ecfr.gov/cgi-bin/text- idx?SID=f100ecfeaa4b4f7032c97c20d7746886&node=sp42.4.433.c&rgn=div6
45 CFR Part 95 (f): http://www.ecfr.gov/cgi-bin/text-
idx?SID=735a4beac7b39103a5c80483d3ffa209&node=sp45.1.95.f&rgn=div6
State Medicaid Manual Part 11: http://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021927.html
CMS Seven Conditions and Standards: http://www.medicaid.gov/Medicaid-CHIP-
Program-Information/By-Topics/Data-and-Systems/Downloads/EFR-Seven-
Conditions- and-Standards.pdf
CMS MMIS Certification Toolkit and Checklist: http://www.cms.gov/Research-
Statistics- Data-and-Systems/Computer-Data-and-Systems/MMIS/MECT.html
Privacy and Security Standards – NIST Special Publications:
http://csrc.nist.gov/publications/PubsSPs.html
CMS MITA: http://www.medicaid.gov/medicaid-chip-program-information/by-
topics/data- and-systems/medicaid-information-technology-architecture-mita.html
NM 2015 MITA 3.0 State Self-Assessment, on the NMHSD website:
http://www.hsd.state.nm.us
HIPAA and ACA: Administrative Simplification Overview https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/index.html https://nmhsd-
public.sharepoint.com/Pages/HSDProcurementLibrary.aspx.: The library
contains reference documents related to this procurement, including:
1. HHS 2020 Roles and Responsibilities
2. HHS 2020 Background Information NM HHS and Medicaid
3. HHS 2020 Work Flows
4. HHS 2020 Stakeholder Relationship Diagrams
5. HHS 2020 User Views
6. HHS 2020 Data Flows
7. HHS 2020 Acronyms
8. HHS 2020 Terms and Definitions
9. HHS 2020 Activity Data
10. HHS 2020 CMS Seven Standards and Conditions
11. HHS 2020 Overview of the NM Medicaid Program
12. HHS 2020 Legacy Interfaces
13. HHS2020 Data Needs for Reporting
14. HHS 2020 Security Privacy and Standard
15. HHS 2020 Turnover Plan
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