CMS-10185.Summary of Revisions

Revisions to 2^nd Draft of CY2012 Part D Reporting Requirements

Eight organizations submitted 35 comments to the 1^st draft of the Part D CY2012 Reporting Requirements. The table below summarizes the revisions made for the 2^nd drafts of the CY2012 Part D Reporting Requirements.

Part D Changes
#	Category	Section	Change/Reason	Effect to reporting burden
1	Response to Public Comments	Coverage Determinations and Exceptions	Revised date elements C, F, I, and L to include the word “made” instead of the word “processed” to clarify that cases should be reported based on the date of decision.	None
2	Lessons Learned	Grievances	Revised introduction to state, “Sponsors should report data based on the date the grievance decision was made.” This revision is consistent with other Part C and Part D reporting sections.	None
3	Response to Public Comments	Long-Term Care Utilization and Waste	Separated into two sections: (1) LTC Utilization and (2) LTC Waste and reordered data elements to distinguish those data elements associated with LTC Waste from those data elements associated with LTC Waste due to pending reg CMS-4144-P.	None
4	Response to Public Comments	Long-Term Care Utilization and Waste	Revised and re-ordered data elements D.6, D.8, D.9 to clarify that total cost for waste reporting should only include ingredient cost.	None
5	Response to Public Comments	Long-Term Care Utilization and Waste	Revised and re-ordered data elements within D.9. These data elements will now refer to dispensing methodologies, which will be defined in the technical specifications. In addition, revisions made to clarify that unused drugs should be reported.	None
6	Lessons Learned	Long-Term Care Utilization and Waste	Revised introduction to clarify regulation changes in reg CMS-4144-P.	None
7	Lessons Learned	Medication Therapy Management Programs	Revised data element L to clarify that the date of offer should be the initial date.	None
8	Lessons Learned	Medication Therapy Management Programs	Revised data element M to include the abbreviation CMR.	None
#	Category	Section	Change/Reason	Effect to reporting burden
9	Lessons Learned	Medication Therapy Management Programs	Revised data element N to specify that more than one CMR date may be entered if applicable.	None
10	Response to Public Comments	Redeterminations	Added additional language to the introduction to clarify that redeterminations should be reported based on date of redetermination decision.	None
11	Response to Public Comments	Enrollment and Disenrollment	Revised the introduction due to CMS’ enrollment processing changes effective 4/18/2011.	None
12	Response to Public Comments	Enrollment and Disenrollment	Revised data element 1.B to clarify the definition of “complete.”	None
13	Lessons Learned	Enrollment and Disenrollment	Revised data element 1.D to clarify the party making the determination and party that is ineligible.	None
14	Lessons Learned	Enrollment and Disenrollment	Revised data element 1.F to clarify that type of enrollment requests denials that should be reported.	None
15	Lessons Learned	Enrollment and Disenrollment	Revised data element 1.H to remove the word “plan” to be consistent with data element 1.I.	None
16	Response to Public Comments	Enrollment and Disenrollment	Revised data element I.J to clarify what is meant by “employed agents and brokers.”	None
17	Response to Public Comments	Enrollment and Disenrollment	Removed data element 1.M, 1.Q, 1.R, and 1.S due to CMS already having access to this data.	Decrease
18	Response to Public Comments	Enrollment and Disenrollment	Added an additional data element – data element 1.P – to capture the number of enrollment transactions for individuals affected by a contract renewal, plan termination or service area reduction.	Increase
19	Response to Public Comments	Enrollment and Disenrollment	Revised data element 2.A to clarify that voluntary disenrollment requests should be reported.	None
20	Response to Public Comments	Enrollment and Disenrollment	Revised data element 2.B to clarify what is meant by “complete.”	None
21	Response to Public Comments	Enrollment and Disenrollment	Revised data element 2.C to clarify that the number of denied disenrollment requests reported should include all denials.	None
22	Response to Public Comments	Enrollment and Disenrollment	Deleted data element 2.D due to CMS already having access to this data.	None

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