CMS-10142 Attachment C, CY2010 BPT changes PRA

Attachment C
Summary of Changes – CY2010 Bid Pricing Tool (BPT)
Paperwork Reduction Act Submission
OMB # 0938 – 0944
CMS-10142
December 19, 2008 Revisions
The following revisions are in response to the CY2009 Lessons Learned Survey from
industry, feedback from bid reviewers and internal CMS review of the BPT. They do not
change the estimated burden to the plan sponsors.
1) Revised labels: Annual update of displayed labels (for example: CY2009 → CY2010)
Locations: PD BPT Worksheet 1 cells N3, F5, C29:C32
PD BPT Worksheet 7 cells C10:C12, B9
MA BPT Worksheet 1 cells P3, D8
MA BPT Worksheet 5 cells J16
MA BPT Worksheet 6 cells E14
MSA BPT Worksheet 1 cells P3, D8
MSA BPT Worksheet 4 cells H48, H53
2YRLB cell P7, L6
Reason: To improve user-friendliness / accuracy of BPT.
2) New input fields: Enter PD LIS member months.
Location: PD BPT Worksheet 1 Section II line 2
Reason: Lessons Learned comment from reviewers or industry.
3) Revised calculated fields: PD credibility percentage, PD projected unit cost, PD
projected allowed PMPM, MA Projected Allowed, MA total credibility, MA total bid
rounded, MSA Projected Allowed, MSA total credibility
Locations: PD BPT Worksheet 2 cells O49:O56, J49:J56, K40:K47, O16:O32.
MA BPT Worksheet 2 cells H20:H37, L38, L40
MA BPT Worksheet 4 cell N48
MSA BPT Worksheet 2 cells H20:H31, L32
Reason: Lessons Learned comment from reviewers or industry.
4) New calculated field: CMS credibility formula.
Locations: PD BPT Worksheet 2 cell O57
MA BPT Worksheet 2 cell L39
MSA BPT Worksheet 2 cell M33
Reason: Lessons Learned comment from reviewers or industry.

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5) Revised input field options: Drop-down box entries changed to: “no deductible”,
“applies to all tiers” and “applies to some tiers”.
Location: PD BPT Worksheet 5 cell I33
Reason: Lessons Learned comment from reviewers or industry.
6) New optional input field: Working Model text box.
Locations: PD Worksheet 7 cells H17:J32
MA BPT Worksheet 6 cells H41:K55
Reason: Lessons Learned comment from reviewers or industry.
7) New input fields: Three Yes/No drop-down boxes regarding the OOP maximum.
Location: MA Worksheet 3 Section II Lines 1-3
Reason: Lessons Learned comment from reviewers or industry
8) Remove input and calculated fields: Part B Only premium for Part A services
Location: MA Worksheet 6 Section IIA lines 2-3
Reason: Lessons Learned comment from reviewers or industry
9) Reposition/relocate input and calculated fields: move section due to deleted fields
Location: MA Worksheet 6 Section IIB
Reason: Lessons Learned comment from reviewers or industry
10) The following changes are related to dual eligible enrollees.
Reason: Improve accuracy of BPT calculations for dual eligible enrollees.
Removed input and calculated fields: Percentage dual enrollees.
Location: MA BPT Worksheet 1 cell P8, WS2 P8, WS3 N8, WS4 Q8, WS5 N8, WS6
Q8, WS7 Q8
New input and calculated fields: Base period non-dual and dual member months and
risk scores.
Location: MA BPT Worksheet 1 cells J13:K14
New input and calculated fields: Non-dual and dual allowed PMPM.
Location: MA BPT Worksheet 2 cells P20:Q40
New calculated fields: Display non-dual and dual member months and risk scores.
Location: MA BPT Worksheet 2 cells O13:Q14
New input and calculated fields: Nondual and dual revenue summary
Location: MA BPT Worksheet 4 Sections IIA and B
Revised calculated fields: Total revenue summary
Location: MA BPT Worksheet 4 Section IIC
New Input fields: Medicaid benefits and revenue for duals.
Location: MA BPT Worksheet 4 Section V

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New input and calculated fields: Non-dual and dual member months and risk score
Location: MA BPT Worksheet 5 Section II Lines 1 and 4
Reposition/relocate input and calculated fields: move section due to new fields
Location: MA BPT Worksheet 5 Section IV
Remove calculated fields: Allowed and cost sharing
Location: MA BPT Worksheet 6 cells D23:E24
11) Change input cells to be calculated cells: Optional Supplemental package IDs.
Locations: MA BPT Worksheet 7 cells B17, B40, B63, B86, B109
MSA BPT Worksheet 7 cells B17, B40, B63, B86, B109
Reason: Lessons Learned comment from reviewers or industry
September 25, 2008 Revisions
There are no structural changes to the CY2010 MA and PD BPT. The labels were
updated from Contract Year 2009 to 2010.
The revisions were necessary for accuracy. The revisions were not made as the result of
a change in statute or regulation and neither increase nor decrease the burden.

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