J.10 Connectivity request for the MDCN .DOC

Attachment J.10 attacment j.10 Connectivity request for the mdcn

For CMS Use Only Application Number: ______________

CMS CONNECTIVITY REQUEST

for the Part D Eligibility Index and the TrOOP Facilitation Process

The following organization is requesting connectivity to the CMS for the Part D Eligibility Index and TrOOP Facilitation.

Organization Name:

Applicant's Primary Contact:

Applicant's Primary Contact Telephone Number:

Applicant's Telecommunications Contact:

Applicant's Telecommunications Contact Email:

Address:

Physical Site Address:

(Include City, State, Zip) Please note: The physical site address must be the physical location for the T1 installation.

1. Does your site have leased line IP connectivity into the MDCN (Medicare Data Communications Network) via AGNS (AT&T Global Network Services)?

____ Yes. Please answer questions 2-13.

____ No. Please answer questions 4-13.

2. What are the AGNS account names; i.e. BXKY, BXSC, CWF3, associated with the physical location to be used for drug card transactions? (For example, the AGNS account for the IP connectivity into the CMS central office is HCFA)

3. Are there other locations networked to the physical site? If so, please list the city and state below.

4. What are the IP networks/sub-network masks that will be communicating with CMS? (This is required for both ends of the connectivity so routing can be put in place over the new PVC built across the AGNS.) Please note you may need to contact your network administrator for this information.

NOTE: If the AGNS router is placed on a ring/segment upstream from the origination network(s), CMS will need to know what the next hop will be out of the AGNS router to get to the cascaded network(s).

5. Do you currently have Connect:Direct that you will use for the Part D Eligibility Index and the TrOOP Facilitation Process within your system infrastructure?

____ Yes. Please answer question a below.

____ No. Please answer questions b and c below.

a. Which version of Connect:Direct to you currently have within your infrastructure; i.e., enterprise, workstation (runs on PC) or satellite (LAN/Server based)?

b. Please provide the following information for Connect:Direct software installation on the hardware resident within your infrastructure.

Make & Model of Hardware Where Software Will Reside:

Number of Processors Associated with this Hardware:

Operating System Used on the Hardware:

c. Who is the contact person(s) who will be responsible for the Connect:Direct software?

Name:

Phone Number:

Email Address:

6. For T1 installation, what type of LAN will connect to the CMS router; i.e. ethernet, token ring?

7. Will this new site require non-portable registered IP addresses from AGNS?

If so, how many? _______

If not, what addresses will be used at this site (sub-network/mask) and what IP address/sub-network mask should be used as the LAN interface address on the AGNS router?

8. What protocols will need to be enabled for this site; i.e., IP, SNA?

9. Will this site require the use of a dynamic routing protocol to advertise/learn routes to/from the AT&T Business Services network; i.e. IGRP, EIGRP, OSPF, BGP? If not, CMS will assume static routes should be used on the router placed at the new site.

10. What IP network(s) or host(s) at this site, including sub-network mask(s), will need to be able to communicate with what IP network(s) or host(s) at other sites and vice versa? Please include sub-network masks for the destination network(s) as well.

NOTE: If the AGNS router is placed on a ring/segment upstream from the origination network(s), CMS will need to know what the next hop will be out of the AGNS router to get to the cascaded network(s).

11. Does this site have connectivity out to the Internet?

12. If there is connectivity out to the Internet, please describe the firewall used at the site for which this is applicable.

· Socks or proxy

· Firewall software/hardware

· Is there any unsolicited inbound traffic permitted from the Internet through the firewall?

· Will AGNS MDCN WAN be connected to the secure side of the firewall?

13. Are there any dial-up connectivity requirements to the sub-network(s) at this site?

Questions about completing the CMS Connectivity Request should be sent to MDCN@CMS.HHS.GOV with TrOOP Facilitation Process as the subject line TrOOP Facilitation SOW