Lessons
learned
|
All
|
Where
applicable, the term Part D Contract was replaced with Part D
Sponsor. The term Part D Contract had sometimes caused
confusion.
|
No
change in burden
|
Response
to Public Comments
|
Section
I - Retail, Home Infusion and Long-Term Care Pharmacy Access
|
Reduction
in the reporting frequency for subsections A and B. Data from
one quarter only will be collected on an annual basis.
Previously, data would be collected and submitted biannually.
|
Decrease
in burden
|
Lessons
learned
|
Section
I - Retail, Home Infusion and Long-Term Care Pharmacy Access
|
Clarification
was added to exclude PACE organizations from reporting data for
subsections A and B. This is consistent with other reporting
sections which exclude PACE organizations from reporting.
|
No
change in burden
|
Lessons
learned
|
Section
I - Retail, Home Infusion and Long-Term Care Pharmacy Access
|
Addition
of two subsections C and D only for those Part D Sponsors which
received waivers for any willing pharmacy requirement and/or the
retail convenient access requirement after the initial pharmacy
access submission. Those Sponsors will submit these data at the
Plan (PBP) level, on an annual basis. These subsections are
necessary given the information collected by subsection A of this
reporting section.
|
Increase
in burden
|
Lessons
learned
|
Section
I - Retail, Home Infusion and Long-Term Care Pharmacy Access
|
Subsection
B revised to state tab delimited text files will be uploaded.
Excel files had previously been listed as the type of files to be
uploaded, however tab delimited text files are required by the
application to which they will be uploaded.
|
No
change in burden
|
Response
to Public Comments
|
Section
III -Vaccines
|
Clarifications
were made to data elements A-D. A correction was made to data
element F.
|
No
change in burden
|
Response
to Public Comments
|
Section
V - Medication Management Therapy Programs
|
The
reporting timelines for both subsections were revised to list YTD
instead of Period 2.
|
No
change in burden
|
Lessons
learned
|
Section
V - Medication Management Therapy Programs
|
Subsection
B was revised to state that tab delimited text files will be
uploaded. Additionally, this statement was added: “Part D
Sponsors will upload files using Gentran or Connect Direct. More
information regarding the upload will be forthcoming.” A
record layout was provided. Excel files had previously been
listed as the type of files to be uploaded, however tab delimited
text files are required for efficient submission by Sponsors.
|
No
change in burden
|
Response
to Public Comments
|
Section
V - Medication Management Therapy Programs
|
Addition
of a field in the text file to indicate if a MTM participant was
a LTC resident. Other fields’ labels were clarified.
|
Increase
in burden
|
Response
to Public Comments
|
Section
VII - Home Infusion Utilization
|
The
term “home infusion drug” was defined.
|
No
change in burden
|
Response
to Public Comments
|
Section
VII - Home Infusion Utilization
|
Data
elements A and B were deleted. Data element D was clarified.
|
Decrease
in burden
|
Response
to Public Comments
|
Section
VIII- Grievances
|
Clarification
was made that plans should not dismiss or exclude any grievances
filed by beneficiaries or their appointed representatives from
this reporting section.
|
No
change in burden
|
Response
to Public Comments
|
Section
X -Transition
|
Clarification
was made that only one quarter of data would be collected and
reported annually.
|
No
change in burden
|
Lessons
learned
|
Section
XI -Exceptions
|
Clarification
was made to include prior authorization requests/approvals that
relate to Part B vs. Part D coverage. Previously, Sponsors were
instructed to exclude these types of requests/approvals from this
reporting, and this potentially caused inaccuracies.
|
No
change in burden
|
Lessons
learned
|
Section
XIV -Pharmaceutical Manufacturer Rebates, Discounts, and Other
Price Concessions
|
Correction
that tab delimited text files will be uploaded. Excel files had
previously been listed as the types of files to be uploaded,
however tab delimited text files are required by the application
to which they will be uploaded.
|
No
change in burden
|
Lessons
learned
|
Section
XV - Long-Term Care (LTC) Rebates
|
Correction
that tab delimited text files will be uploaded, and should
include character fields. Excel files had previously been listed
as the types of files to be uploaded, however tab delimited text
files are required by the application to which they will be
uploaded. Instructions for reporting special cases were added.
As these instructions became effective for CY2007, they must be
included for CY2008.
|
No
change in burden
|
Lessons
learned
|
Section
XVI -Licensure & Solvency
|
The
terms “Part D Employer/Union Only Group Waiver” were
replaced with “Employer/Union Direct Contract”, and
“Direct EGWPs” replaced with “Direct Contract
PDP”. The previous terminology had sometimes caused
confusion.
|
No
change in burden
|
Lessons
learned
|
Section
XVI -Licensure & Solvency
|
Move
of Subsection IV. Performance of Part D Activities data to
Pharmacy & Therapeutics (P&T) Committees Section. In
CY2007, this subsection was created as an extension of the
business and financially related data elements reported. It is,
however, more closely related to the data reported in the P&T
Committees section.
|
No
change in burden
|