Table : Program Management Detailed Results Kentucky MITA Action to Meet MITA To Be Business Process Condition/Standard Capability Gap and 7C&S PG01 Designate Approved Process seeks and uses Business Results Condition Automate input gathering Service/Drug input from various activities to promote greater Formulary sources efficiency and effective data sharing PG01 Designate Approved Process involves Industry Standard Condition Use MITA standards and Service/Drug utilization and interfaces to increase efficiency Formulary implementation of and consistency current service codes and schemes PG02 Develop and maintain Process utilizes input Business Results Condition Automate review of electronic benefit package from Federal and State sources (in order to alert agencies, and interacts Commonwealth personnel of with multiple external changes) agencies PG02 Develop and maintain Process involves Industry Standard Condition Use MITA standards and benefit package utilization and interfaces to increase efficiency implementation of and consistency current service codes and schemes PG02 Develop and maintain Performance and Reporting Condition Automate and schedule the benefit package utilization of benefit plans comparison of benefit plan is evaluated performance and utilization PG03 Manage Rate Setting Process is initiated by Business Results Condition Automate the gathering of regularly scheduled rate information (within the Medicaid modifications and ad-hoc Enterprise system) and rate requests calculation
Table : Program Management Detailed Results Business Process Kentucky MITA Capability Gap Condition/Standard Action to Meet MITA To Be and 7C&S PG01 Designate Approved Service/Drug Formulary Process seeks and uses input from various sources Business Results Condition Automate input gathering activities to promote greater efficiency and effective data sharing PG01 Designate Approved Service/Drug Formulary Process involves utilization and implementation of current service codes and schemes Industry Standard Condition Use MITA standards and interfaces to increase efficiency and consistency PG02 Develop and maintain benefit package Process utilizes input from Federal and State agencies, and interacts with multiple external agencies Business Results Condition Automate review of electronic sources (in order to alert Commonwealth personnel of changes) PG02 Develop and maintain benefit package Process involves utilization and implementation of current service codes and schemes Industry Standard Condition Use MITA standards and interfaces to increase efficiency and consistency PG02 Develop and maintain benefit package Performance and utilization of benefit plans is evaluated Reporting Condition Automate and schedule the comparison of benefit plan performance and utilization PG03 Manage Rate Setting Process is initiated by regularly scheduled rate modifications and ad-hoc requests Business Results Condition Automate the gathering of information (within the Medicaid Enterprise system) and rate calculation