TRK-Attachment I

Attachment I: Part C Reporting Overview

Measure	Type Plans Required to Report	Report Freq./ Level	Report Period (s)	Data Due date (s)
1. Benefit Utilization	CCP, PFFS, 800 series, 1876 Cost, Demo, MSA CCP, PFFS, Demo, MSA, SNPs (includes all 800 series plans), Employer/Union Direct Contract	1/year PBP	1/1-12/31	5/31/09 for CY 2007 data and 7/31/09 for CY 2008 data. After that, 5/31 of following year. 8/31 of the following year.
2. Procedure Frequency	CCP, PFFS, 800 series, 1876 Cost, Demo, MSA CCP, PFFS, Demo, MSA (includes all 800 series plans) , Employer/Union Direct Contract	1/year Contract	1/1-12/31	2/28 of following year 5/31 of following year
3. Serious Reportable Adverse Events	CCP, PFFS, 800 series, 1876 Cost, Demo, MSA CCP, PFFS, Demo, MSA (includes all 800 series plans) , Employer/Union Direct Contract	1/year Contract	1/1-12/31	2/28 of following year 5/31 of following year
4. Provider Network Adequacy	CCP, 1876 Cost, Demo (includes all 800 series plans) CCP, PFFS, 800 series, 1876 Cost, Demo, MSA	2 1/year Contract	1/1 -6/30 7/1-12/311/1-12/31	8/31 2/28 of following year
5. Grievances	CCP, PFFS, 1876 Cost, Demo, MSA (includes all 800 series plans) , Employer/Union Direct ContractCCP, PFFS, 800 series, 1876 Cost, Demo, MSA	4/Year Contract	1/1-3/31 4/1-6/30 7/1-9/30 10/1-12/31	5/31 8/31 11/30 2/28 of following year
6. Organization Determinations/ Reconsiderations	CCP, PFFS, 1876 Cost, Demo, MSA (includes all 800 series plans) , Employer/Union Direct Contract CCP, PFFS, 800 series, 1876 Cost, Demo, MSA	4/Year Contract	1/1-3/31 4/1-6/30 7/1-9/30 10/1-12/31	5/31 8/31 11/30 2/28 of following year
7. Employer Group Plan Sponsors	CCP, PFFS, 1876 Cost, Demo, MSA (includes sponsors of individual plans and 800 series plans) All individual MA plans and “800 series” MA Plans sponsored by employer groups	2/year PBP	1/1 -6/30 7/1-12/31	8/31 2/28 of following year
8. PFFS Plan Enrollment Verification Calls	PFFSPFFS, 800 series	1/year PBP	1/1-12/31	2/28 of following year

9. PFFS Provider Payment Dispute Resolution Process	PFFS (includes all 800 series plans) , Employer/Union Direct Contract PFFS, 800 series	1/year PBP	1/1-12/31	2/28 of following year
10. Agent Commission Structure	CCP, PFFS, 1876 Cost, Demo, MSA (includes all 800 series plans) CCP, PFFS, 800 series, 1876 Cost, Demo, MSA	1/year Contract	1/1-12/31	2/28 of following year
11. Agent Training and Testing	CCP, PFFS, 1876 Cost, Demo, MSACCP, PFFS, 800 series, 1876 Cost, Demo, MSA	1/year Contract	1/1-12/31	2/28 of following year
12. Plan Oversight of Agents	CCP, PFFS, 1876 Cost, Demo, MSA (includes all 800 series plans) CCP, PFFS, 800 series, 1876 Cost, Demo, MSA	4/Year Contract	1/1-3/31 4/1-6/30 7/1-9/30 10/1-12/31	5/31 8/31 11/30 2/28 of following year
13. SNPS Care Management	SNPs (includes all 800 series plans)	1/Year/PBP	1/1-12/31	5/31 of following year