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Status Report on Major Crown/Transformational Projects

1. Description:

Health Information and Claims Processing Services (HICPS) Major Crown Project.

HICPS is the key delivery mechanism for the payment of pharmacy, medical supplies and equipment, and dental benefits under Health Canada's Non-Insured Health Benefits (NIHB) Program.

The HICPS Project was established to conduct a competitive procurement to replace the existing HICPS contract, to manage the implementation of the new service contract and ensure a smooth transition from the current incumbent to the new contractor.

2. Project Phase:

Project Close-Out Phase: The HICPS Major Crown Project entered the project close-out phase upon implementation of the new Health Information and Claims Processing Services into production on December 1, 2009.

Overview: HICPS supports the delivery of much-needed health benefits for over 830,000 eligible First Nations and Inuit clients. ESI Canada commenced operations in December 2009 with implementation of the new HICPS system. Transition between the previous claims processor and the new Contractor was managed without major impact to Non-Insured Health Benefits' First Nation and Inuit Clients.

3. Leading and Participating Departments and Agencies
Lead Department Health Canada
Contracting Authority Public Works and Government Services Canada
Participating Departments Indian and Northern Affairs Canada

4. Prime and Major Subcontractor(s)
Prime Contractor ESI Canada, Mississauga, Ontario, Canada
Major Subcontractor(s) ESI, IBM Canada

5. Major Milestones
Major Milestones Date
Initial meetings with Contractor, coordination of implementation phase project plan Contract Award (December 4, 2007 through January 2008)
Business Requirements Gathering and Design February 2008 to August 2008
HICPS Development September 2008 to April 2009
HICPS Testing and Acceptance May to September 2009
HICPS Implementation (ESI Canada officially takes over real-time service provision) December 1, 2009
Project Close-Out Phase: Evaluation of the HICPS Project and lessons learned. December 2009 to March 2011
Documentation, Simulations, Validation, Data Conversion and Training September 2009 to November 2009
HICPS Implementation (ESI Canada officially takes over real-time service provision) December 1, 2009
Project Close-Out Phase: Evaluation of the HICPS Project and lessons learned. December 2010 to March 2011

6. Project Outcomes

The Implementation Phase of the HICPS project was concluded on time and on budget in December 2009. All steps were taken to ensure a seamless transition to Non-Insured Health Benefits clients. Some system adjustments and enrolment of providers continued after system implementation. However, the new HICPS system is successfully processing pharmacy, dental, and MS&E benefits for First Nation and Inuit clients.

The Project has now entered the Close-Out Phase and an evaluation will be completed of the HICPS project and lessons learned. The close-out phase is scheduled to be completed by March 2011.

The project schedule and budget is consistent with the amount granted by the project authorities.

7. Progress Report and Explanations of Variances

HICPS was implemented on December 5, 2009 and transition completed between the two service contracts.

For fiscal 2010-11, the focus of this initiative will be on refinement of the services and the system project evaluation and project close-out.

8. Industrial Benefits

The Industrial Regional Benefits (IRB) model was modified to focus on benefiting the Aboriginal economic community, rather than a specific industry or region of Canada, resulting in an Aboriginal benefit requirement (ABR) which is unique to the HICPS Project.

The development of the ABR approach for the HICPS Project was informed by industry feedback through two Requests for Information (RFI) consultation processes, and approved by Treasury Board. As HICPS Prime Contractor, ESI Canada is required to ensure a mandatory and substantial Aboriginal benefits requirement representing direct or indirect benefits to Aboriginal businesses or individuals.