MPSM Newsletter - March 2024
Program News
Dental MVP Launch: Full Speed Ahead
The MPSM Dental Teams are very close to completing a Minimum Viable Product (MVP) that will, ingest, adjudicate, and pay 100% of dental claims received! The first few months of 2024 have seen a lot of activity as the dental teams worked to incorporate additional functionality that would make it easier for Medicare Administrative Contractors (MAC)s to navigate between claims. Additionally, the last dental API needed for the MVP went into production on February 26th.
MAC training is scheduled to begin March 21st, but MACs are already conducting end-to-end testing on the system in order to provide feedback to the dental teams. The teams have been holding weekly meetings with the MACs to demo the new functionality and confirm the issues identified have been addressed. The goal is to thoroughly test the Dental MVP and resolve any known issues before the launch.
MPSM plans to launch the dental claims processing system incrementally and has already begun processing a small number of test claims, submitted by MACs, in the production environment. The MVP is now ready for the next step, which is receiving test claims, or “T” claims from clearinghouses participating in the launch.
Once MACs have successfully processed T claims and have met other requirements, they will begin processing a very small number of real claims before accepting electronic dental claims on a larger scale. This incremental approach ensures that claims can be processed in production and that all the services and integrations are working as expected.
First MAC Successfully Integrates with PCS-API
The Pricing and Coding Services (PCS) team has been working with the MACs to ensure they can access the PCS-API and retrieve all the data that they need from the fee schedules. In February, the first Part B MAC successfully integrated with the PCS-API and subsequently provided a demo of the integration for the other Part B MACs where it was noted that, “The manual process is time consuming and could be error prone. The batch automation job is really fast, it runs under 2 minutes!”
Indeed, during the demo they were able to pull about 100 reports in less than 2 minutes. The MACs estimate that this automated process, replacing manual steps, will save them 300-400 hours of manual work per year for one report type, with 300 hours estimated just for CY24 Q1! Since that time, a second MAC has integrated and the feedback has been very positive with one MAC commenting in an interview about report history maintenance, "It's easy [accessing reports from the PCS-API integration] and better than going into CA-View [for report history]. The API is working out for us.”
This MAC integration and the associated efficiencies gained is a significant accomplishment for the PCS team and for the MPSM program. It is encouraging to see the direct impact the modernization efforts are having on the users.
Team Spotlight
MPSM COBOL Modernization (COMO)
We’re pleased to introduce the newest ADO Team to join MPSM! The MPSM COBOL Modernization team aims to convert COBOL to Java in a way that enables it to run on the mainframe and replatform it to the cloud where it can be renovated into a more modern system, something previous modernization strategies did not permit us to do. The hope is that this approach will reduce the technical and business obstacles while accelerating the development and modernizing the current system. The team is also exploring the use of AI-assisted tools and identifying resources that will help speed up the development of COBOL to Java.
To help MPSM drive change for the program and stakeholders, one of the first initiatives the team will be tackling is the development of a relationship map of the system with all the interdependencies identified. The system map will support data-driven decision-making for determining which code should be prioritized and converted first. The team will also look to implement automated testing and a parallel testing strategy to speed up the conversion process.
The proof-of-concept (POC) that the team is developing will allow them to build and standardize the process of converting the code by creating a framework that is built on components that are reusable throughout the system. The use of reusable components minimizes inter-team dependencies while allowing for faster coding speed, leading to a reduction of time and resources spent on this process.
The MPSM COMO Team plans to work closely with other modernization efforts and members of the Division of Shared System Maintainers (DSSM). To learn more about the MPSM COMO team, reach out to Andrea Gepner (Fed PM), Stefan Falke (Proxy Product Owner), or Pat Sier (Technical Advisor). Read more about the strategy for modernizing COBOL Systems on Confluence.
What’s Ahead?
Stay up to date on recent and upcoming MPSM activities!
MPSM Quarterly Planning (QP) will take place April 9-11, 2024. QP is a three-day virtual event where teams meet to discuss objectives for FY24 Q3 and narrow down the outcomes and methods planned to deliver business value. View the QP agenda here and stay tuned for the updated MPSM Product Reference Sheet (PRS), a high-level summary of recent progress and upcoming goals.