15. Will users access this data through our proposed solution only, or through the legacy systems, or

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1 1. Will you provide a breakdown of the different case types that you hear, and the approximate annual volume of each type? Program eligibility for the Medicaid program and eligibility determinations for the Exchange, medical & social services 2. How many hearing officers hear cases, and are they full time employees of the Department of Human Services. We currently have 30 judges that hear cases for human services and Medicaid. We have not determined how many additional judges we will need, but we anticipate an additional 10 judges for human services/medicaid/aptc. The number of judges needed for the Small Employer's Health Option (SHOP) hasn't been determined yet either. 3. What is the total number of users you anticipate having access to the case management system? 150 DHS users 4. How many staff (other than hearing officers) supports the appeal process? How many documents do you anticipate needing for go live? This is part of the requirements which have not been fully defined. 6. How many reports do you anticipate needing for go live? This is part of the requirements which have not been fully defined. 7. One of the goals of the project is to interface with current electronic filing functionality and electronic document management system. Does this mean that the Department of Human Services has an electronic filing system and an electronic document management system to which you want the vendor to interface, or do you want the vendor to provide those? The MN DHS currently uses IBM FileNet for the electronic document management system and yes the department expects the Appeals system to interface with it. 8. Do you anticipate the need for a data conversion? Yes data conversion will be necessary 9. How many systems is the data coming from? There s potential that data will come from 3 4 systems, short term MMIS, MAXIS, PRISIM long term a new system that s being developed, Exchange and MMIS 10. In what formats? Most likely using Web services and API. 11. What is the volume of information on each system? Currently there are approximately 10,000 appeals submitted each year with their supporting documentation. This will undoubtedly will be a higher volume with the addition of the Exchange appeals. 12. Is case data currently cross-referenced between systems or program areas, and if so, how? Appeals data is not currently cross referenced between systems 13. Is all data from each area to be shared across the system or is segregation of data required? Only specific data will be required for the Appeals database. 14. What legacy information is to be transferred to the new database (i.e. entire history, 2 years)? Entire history

2 15. Will users access this data through our proposed solution only, or through the legacy systems, or some combination? Users will access data through the Appeals application 16. Will legacy systems require access to the new database, and if so, will there be custom interface requirements? This scope item is yet to be determined. 17. Will the state require access to the system? If so, how many people would that entail? We anticipate approximately 150 DHS and Exchange staff accessing the system. 18. How many imports will be requires? This will be part of the requirements definition 19. Patient demographics We will most likely use web services where currently available and may need to build a dynamic API to obtain client data 20. Provider data If provider data is needed to process a client s appeal, we will most likely use web services where currently available and may need to build a dynamic API to obtain provider data. 21. Appeals from multiple sources Client appeals may be submitted hard copy, electronically, internet or by phone. The solution will need to accommodate all forms of information process described in the regulations. 22. Document management (really need more information as to what exactly the document management consists of) FileNet is the document management system that the Appeals system will interface with. 23. What is meant by the MN exchange? The MN Exchange is the online marketplace where Minnesotans can purchase private health insurance or enroll in public programs like Medical Assistance and the Children s Health Insurance Program (CHIP). See for more information on the MN Exchange. 24. What kind of training, technical and user is required? Users and staff that support the system will require training. Using a knowledge transfer model for the technical staff. 25. Can a description of current tracking systems be provided? For human services programs, this is mostly a manual process with limited tracking by some program areas using SharePoint and a DHS custom built database. For the Exchange, there is currently no functionality being built into the solution. Regulations were published this week that the solution must accommodate See: /medicaid childrenshealth insurance programs and exchanges essential health benefits in alternative 26. What program areas will utilize this process? The Exchange, Medicaid and Social Service programs will utilize the system. 27. What security restrictions will be required (eg. Can users only view appeals from within designated program area, etc)?

3 We don t have all the specific security requirements defined yet, but the solution will need to adhere to HIPAA minimum necessary requirements, so this is a likely security restriction. We anticipate a role based security solution 28. What appeal information collection process is desired (eg. Internet form)? We currently accept phone calls, paper and internet. The solution will need to accommodate all forms of information process described in the regulations. 29. Can the state provide any procedural documentation or flow charts of the current process? There will be major changes to business processes due to the newly published regulations, so any existing business process flows are mostly irrelevant. For high level existing process information, the following public website contains further details and frequently asked questions regarding the appeals process: ocname=id_008649&revisionselectionmethod=latestreleased 30. Does the state have examples of the tracking and reporting requirements? The attached requirements document is for the Human Services Appeals only and does not include the requirements for the Health Exchange. The document is also old and some of the requirements may be out dated. 31. What interfaces will be required to the line of business systems (eg maxis, prism, smi)? Long term, a New System that we re developing, Exchange, MMIS and short term MAXIS, PRISIM, MMIS. 32. Please elaborate on the current filing functionality requirement? See the next question. Requirements haven t been fully defined. 33. Please confirm that the interface with electronic document management system for the new solution is to FileNet. If an interface to a document management system is required then should respondents assume that documentation will be submitted to this case management system? Can the state provide scenarios, examples, and use cases? Is a taxonomy available related to documents used for the appeals process? Yes the electronic document management system that Appeals will interface with is FileNet. Yes respondents can base their responses on the usage of FileNet I don t have scenarios, examples or use cases at this time. The taxonomy will be part of requirements definitions. 34. Has the State created any data model that they intend to utilize in the design of the new system? There aren t any data models available. 35. How many users are anticipated to require access to the solution? We anticipate approximately 150 users accessing the solution. 36. Will the State please confirm the number of users? We anticipate approximately 150 users for the system. 37. For example, will access and use of the system be limited to the DHS Compliance Office staff or is the intent to allow other DHS workers to access the system in order to initiate Appeals on behalf of clients?

4 Other DHS staff that is part of the appeals process, such as staff from the program areas, will need to have access to the system. MN DHS workers do not submit appeals on behalf of clients. 38. Does the agency intend that clients/applicants be allowed to initiate appeals on their own behalf? Yes clients may initiate appeals on their own. 39. Will the State please provide vendors with the budget allocated to this project? DHS does not have the complete budget figures at this time. 40. Will the State please confirm that RFI Schedule milestone times are CST? For example, is the RFI Response due February 11, :30 P.M. CST? Yes the times are CST. 41. Is it the state s intent to secure a standalone Appeals case management system? The intent is to have an Appeals application that has the ability to seamlessly consume services from other systems. To have an integration across all systems utilizing a SOA 42. Will the State please confirm the number and type of interfaces that will support access to individual and case eligibility information needed to support the Appeals process? This will be part of the requirements which have not been fully defined at this time. 43. Please clarify this requirement. Is it the state s intent to have data for all case types in the appeals case management database such that worker s for all programs can work in one application, or is the state looking for a solution that allows workers to have multiple applications open at the same time to access all relevant data? Multiple workers must be able to access the application simultaneously. If relevant information is not available in the Appeals application, it must have the ability to dynamically access other systems. 44. Will the State please provide details concerning the current electronic filing functionality and electronic management systems? Clients may submit appeals through an online web based application. MN DHS currently utilizes FileNet for its electronic document management system. The Appeals application must be able to interface with the EDMS. 45. Our product is licensed by named users not concurrent, how many users would need access to the system? There will be approximately 150 people requiring access to the case management system. 46. What are you currently using for electronic filing and document management system? We currently use a custom built electronic filing system that connects to FileNet which is our document management system. FileNet is also the management system being used for HIX/System modernization. 47. Are you looking for a custom solution or a commercial off the shelf (COTS) product? DHS is currently leaning towards COTS products, but since we re also interested in seeing what is available to best fit our requirements. 48. Should an RFP be released has the Department determined a time frame? (1 2 years, 3 4 years?) Can information regarding estimated cost and a possible funding source be disclosed at this time?

5 DHS is on a fast track with this project and our timeframe is 1 year. As part of the planning process for Appeals, we are exploring funding options for the application. Enhanced federal participation is expected to be a part of the funding solution. 49. How many total DHS users would there be of the new case management system? We anticipate approximately 150 DHS users of the system. 50. Of those users would any be read only users? i.e. able to read any information in the system but unable to add or alter information in the system. This would not include public users who may be allowed to view case information from the CMS through a public state website. There may be a small number of users that would have read access only. Specific details on case information will not be available through a public website.