508_Compliant_CMS-10142 Attachment C, CY2011 BPT changes PRA

508_Compliant_CMS-10142 Attachment C, CY2011 BPT changes PRA.pdf

Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP)

508_Compliant_CMS-10142 Attachment C, CY2011 BPT changes PRA

OMB: 0938-0944

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Attachment C
Summary of Changes – CY2011 Bid Pricing Tool (BPT)
Paperwork Reduction Act Submission
OMB # 0938 – 0944
CMS-10142
December 17, 2009 Revisions
The following revisions are in response to Lessons Learned feedback from industry,
feedback from bid reviewers and internal feedback from within CMS. They do not result
in a change to the estimated burden.
1) Updated labels: Annual update of displayed labels (for example: CY2010 → CY2011)
Locations: PD Worksheet 1 cells N3, F5, C29:C32
PD Worksheet 7 cells B9, C10:C12
MA Worksheet 1 cells P3, D8
MA Worksheet 5 cell L16
MA Worksheet 6 cell E14
MSA Worksheet 1 cells P3, D8
MSA Worksheet 4 cells H48, H53
MA Ratebook (used in MA Workbook 5)
MA Statutory Rates (used in MA Workbook 5)
MSA Ratebook (used in MSA Workbook 3)
Reason: Update BPT labels to reference Contract Year information.
2) Removed field: Payment Demo Type
Location: PD Worksheets Section I (formerly line 12)
Reason: No longer applicable, as the demonstration has expired.
3) Changed non-input cell to be an input cell: Federal Reinsurance
Location: PD Worksheet 1 cell M31
Reason: To improve accuracy/clarity of BPT.
4) Revised calculated fields: Credibility, Projected Allowed, Blended Allowed, Cost
Sharing, Savings
Locations: PD Worksheet 2 cell O57
MA Worksheet 2 cells L38, L40
MA Worksheet 2, column (h)
MA Worksheet 2 column (o)
MA Worksheet 3 column (l)
MA Worksheet 3, column (q)
MA Worksheet 5, cell E23
MSA Worksheet 2, cell L32
Reason: Changes for technical purposes.

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5) Removed input field: Network Pricing, Intention for full Part B buy-down
Locations: PD Worksheet 3 Section II (formerly line 4)
MA Worksheet 6 Section IIB (formerly line 3)
Reason: To improve accuracy/clarity of BPT.
6) Revised labels: LICS, Base Period, Subtotals, Cost Sharing, ESRD subsidy, ISAR,
Part B premium
Locations: PD Worksheet 3 cell O17
MA Worksheet 1 cells B21, B50, C47
MA Worksheet 2 cell C40
MA Worksheet 3, cells D22:D23
MA Worksheet 4, cell B114
MA Worksheet 5 cells G33:G34
MA Worksheet 6, cells B14, F12
Reason: To improve accuracy/clarity of BPT.
7) Revised input field: Type of Gap Coverage
Location: PD Worksheet 5 cell M33
Reason: The input option for “partial-limited monetary value” is no longer applicable.
8) Removed fields: Two-Year Look-Back Form (2YRLB)
Location: 2YRLB Form
Reason: Added fields to MA Worksheet 1 and eliminated 2YRLB Form.
9) Added fields: Base Period Actual Experience
Locations: MA Worksheet 1 Section III, columns (d) and (e)
MA Worksheet 1 Section VI
Reason: Added fields to MA Worksheet 1 and eliminated 2YRLB Form.
10) Revised input field: Enrollee Type
Location: MA Worksheet 1 Section I line 9
Reason: The input option “Part B Only” is not applicable for regional plans.
11) Added input fields: SNP Type, Unit Cost “Other Factor” Adjustment
Locations: MA Worksheets Section I line 14
MA Worksheet 1 column (o)
Reason: Lessons learned comment from industry/reviewers/CMS, to improve
accuracy/clarity of BPT.
12) Changed input cell to be a non-input cell: Incurred Dates
Location: MA Worksheet 1 Section II line 1
Reason: Lessons learned comment from industry/reviewers/CMS, to improve
accuracy/clarity of BPT.
13) Revised input cells: Plans in Base
Location: MA Worksheet 1 Section II line 5
Reason: Added additional lines for data entry. Lessons learned comment from
industry/reviewers/CMS, to improve accuracy/clarity of BPT.
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14) Revised input field: DE# Allowed PMPM
Location: MA Worksheet 2 Section II column (q)
Reason: Removed default formulas. Lessons learned comment from
industry/reviewers/CMS, to improve accuracy/clarity of BPT.
15) Added input fields: Combined OOP maximum, Optional Supplemental Benefits
Locations: MA Worksheet 3 cell H66
MA Worksheet 7 cells C16, C39, C62, C85, C108
MSA Worksheet 5 cells C16, C39, C62, C85, C108
Reason: Lessons learned comment from industry/reviewers/CMS, to improve
accuracy/clarity of BPT.
16) Added calculated fields: Cost Sharing summary
Locations: MA Worksheet 4 columns (ad) through (aj)
Reason: Lessons learned comment from industry/reviewers/CMS regarding bid reviews.
17) Removed calculated fields: FFS information
Location: MA Worksheet 5 (formerly columns t and u)
Reason: Lessons learned comment from industry/reviewers/CMS. These fields are not
used, and can be removed.
18) Revised input fields: Part D premiums and rebates
Locations: MA Worksheet 6 cells R34, R35, R40, R41
Reason: Fields not applicable for MA-only plans and EGWP plans. Lessons learned
comment from industry/reviewers/CMS, to improve accuracy/clarity of BPT.

September 17, 2009 Revisions
There are no structural changes to the BPT. The “Contract Year” labels were updated.
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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File Typeapplication/pdf
File TitleSummary of Structural Changes – CY2011 BPT
AuthorHHS/CMS
File Modified2009-12-17
File Created2009-12-17

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