TEXAS HHSC - MMIS IV&V

Brief Description: The SES Independent Verification and Validation (IV&V) team, commonly known as the TX Medicaid IV&V project stakeholder, performs as the "Trusted Agent" in a collaborative relationship between the Health and Human Services (HHSC) and interfaces with the Texas Medicaid Health Partnership (TMHP) staff throughout the review process. The TX Medicaid IV&V Team is a corroborative effort of four information technology professionals in north Austin, TX; based on site with HHSC.

The assigned projects for the TX Medicaid IV&V team for the Independent Verification and Validation (IV&V) were a result of federal mandates, which include the National Provider Identifier (NPI) project and the Medicaid Information Technology Architecture (MITA) SS-A project. SES IV&V are also currently supporting the HHSC on other projects such as the Change Order Request (COR) Process Improvement and the STAT Enhancement Data Warehouse development.

The goal of the TX Medicaid IV&V is to identify whether system design and the software products satisfy all the aspects of the requirements, and the assurance of product completeness at each release and increment as per the Software Development Life Cycle (SDLC) is adhered to by the current HHSC Claims Administrator contractor.

The NPI project now implemented, instead of a full remediation provides a crosswalk mechanism to the Texas Medicaid Management Information System (TX MMIS) enterprise, where all systems are modified to process using a new NPI. The crosswalk presents front-end and back-end interfaces of all systems to allow for the acceptance of the NPI, however aligns the NPI with its corresponding Legacy identifier, also known as the Texas Provider Identifier (TPI).

The MITA State Self-Assessment Phase 1 initiative consisted of identifying the current business practices for TX MMIS, commonly referred to as the "As Is" state. This initiative was a compilation of analyses of current business practices and the application of MMIS technologies for reporting to the Center for Medicare and Medicaid Services (CMS).

The TX Medicaid IV&V focuses on the completeness, accuracy, and traceability of the business and system requirements as contractually required per the original HHSC agreement of work.


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