crosswalkCOB

Automatice TrOOP Balance Transfer (ATBT) Process

The addition of the automatic troop balance transfer process (ATBT) is not an additional requirement placed on the plans. The regulation currently requires the Part D sponsors to collect TrOOP information (see 1860D-23 and 1860D-24 of the Social Security Act) CMS enhances this process by contracting with a TrOOP facilitator to “facilitate” this process by routing secondary claims information to Part D sponsors. The TrOOP facilitator contract is being revised to provide additional assistance to the Part D sponsors by automating for plans the TrOOP balance transfers made from one plan to another when a beneficiary disenrolls and re-enrolls into a plan mid-year. Prior to this revision, the plans were required to manually transfer these balances for their beneficiaries when they moved. This is not an additional requirement, but an enhancement to the TrOOP facilitator system that is in place today.

List of Changes to the Current Collection Instrument

REQUIREMENT: Part D sponsors are required to apply protections against high out-of-pocket expenditures by tracking TrOOP expenditures.

SOURCE: 1860D-23, 1860D-24, 42 CFR 423.464

DOCUMENT AND PAGE NUMBER: Automated Troop Balance Transfer Process HPMS Memo – 10/20/2008, Modification to the TrOOP Facilitator Contract – Appendix H.

CITATION: 42 CFR 423.464

REASON WHY CHANGE IS NEEDED: The current TrOOP accounting system does not account for transfer of TrOOP balances when a beneficiary changes plans mid year. Therefore, plans had to transfer the balance via manual process.

IMPACT ON BURDEN: Decreases burden.