Summary of Revisions

Attachment 3

September 22, 2011
Summary of Technical Changes from the 60-Day PRA Package for 2013 Draft Applications

TECHNICAL CHANGES
Clarification

Purpose of the Clarification
PDP

1. Updated background information.

2. Updated schedule.

3. Updated discussion of
performance monitoring
4. Reduce the number of copies of
the PACE Application to be mailed
from 5 to 3.
5. Added language to discussion of
compliance program requirements

6. Added language to attestation to
indicate that the medical director
must be licensed.

GENERAL INFORMATION and INSTRUCTIONS
Pursuant to internal discussion, abbreviated background
1.2
information to eliminate description of statutory
amendments to legislation creating the Part D program.
Pursuant to internal discussion, updated language in
1.4
schedule to indicate that November 11 is the
recommended date by which applicants should submit
their notices of intent to apply in order to ensure that they
have access to HPMS when the application is released.
Pursuant to internal discussion, added a reference to the 1.6.2
regulation that clarifies the scope and authority for
performance monitoring.
Pursuant to internal discussion, reduced the number of
NA
copies of the PACE application that applicants must
provide.
PROGRAM INTEGRITY AND COMPLIANCE PROGRAM
Pursuant to internal discussion, clarified that the
3.1.3
Medicare Compliance Officer could be an employee of
the Applicant, its parent company, or an
affiliate/subsidiary of the Applicant.
COVERAGE DETERMINATIONS
Added clarifying language pursuant to internal discussion 3.9.A

MARKETING AND BENEFICIARY COMMUNICATIONS
7. Deleted language in several
Deleted language pursuant to internal discussion
3.13A
attestations indicating that
because regulations permit oral notification with written
notification of certain
follow up within certain time frames.
decisions/rights must be in writing.
NOTE 1: Nothing in the technical changes table increases burden on the applicant.

1

Application
MA-PD
Cost

PACE

1.2

1.2

1.1

1.4

1.4

NA

1.6.2

1.6.2

NA

NA

NA

2.3

3.1.2

3.1.2

NA

3.10.A

3.8.A

NA

3.14A

3.12A

NA

Attachment 3

September 22, 2011
Summary of Technical Changes from the 60-Day PRA Package for 2013 Draft Applications

NOTE 2: The Service Area Expansion Application is a condensed version of the initial application.

2