Crosswalk - Form C: Quarterly Report

Crosswalk for Changes to Form C.docx

Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program

Crosswalk - Form C: Quarterly Report

OMB: 0938-1016

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Crosswalk for Changes to Form C (OMB 0938-1016)

Section # on Current FORM C OMB #0938-1016

Type of Change

Rationale for Change

I - Business Information

Revised title of Section from, “Business Information,” to, “Contract Information.”

To better reflect the type of information the user will be entering within this section.

I - Business Information

Added “?” for additional information pop-up boxes.

To provide additional detail on the data field and/or when the user can find the required information.

I - Business Information

Added “Does this apply to multiple contracts?” yes/no radio option.


(If yes, two contract number information sections appear with the ability to add a third by clicking on “Add another contract” button.)


To make it easier for the user to apply product updates to multiple contracts (e.g., across one or two rounds of competitive bidding).

I - Business Information

Broke out the “Contract Number” field into two fields to separate the round indicator with the contract number.

To ensure the user enters the round indicator correctly.

I - Business Information

In additional contract number information sections appear (i.e., the multiple contracts radio button is yes), added option for user to select similar product categories for additional contracts added to form. Upon selection of a similar product category, creation of a concise list of Healthcare Common Procedure Coding System (HCPCS) codes will be generated and displayed in the HCPCS Code dropdown, located in the “Update(s) to the Supplier Directory section,” for the supplier to select and enter product information.

To allow the user to provide product information for related product categories where there are exact or similar HCPCS codes.

I - Business Information

Allow user to apply multiple Competitive Bidding Areas to a single product category in the “Review contract and competition information” table.

To reduce the amount of rows on a table and subsequently the number of pages that will be printed by user.

I - Business Information

Revised the “Review contract and competition” table to include a “Contract” column for contract number, and renamed the “Action” column to “Edit.”


To better reflect the type of information the user will be entering within this section.

II – Updates to the Supplier Directory

Revised instructions to align with formatting changes within this section.

To provide accurate instructions to revised form.

II – Updates to the Supplier Directory

Added a “Select an Update Type” radio button.

To clarify the intent of the user to update information on the Supplier Directory with new products, or to overwrite existing information with new information.

II – Updates to the Supplier Directory

Added a “Select how you would like to search for products:” radio button a search by Manufacturer, Model or Model/product number radio button

To allow user to identify which category they would prefer to search for product information (i.e., Manufacturer, Model or Model/product number).

II – Updates to the Supplier Directory

Added a “Search Results” table.

To show result(s) of the user’s search.

II – Updates to the Supplier Directory

Added “Model/Product Number” column to List of Updates to the Supplier Directory table

To ensure they have selected the correct product

II – No Updates to the Supplier Directory

Added contract number as a required field.

To allow user to specify the applicable round for which there are no updates (due to numerous rounds being in effect).

II – No Updates to the Supplier Directory

Added legal business name as a required field

To associate the legal business name with the contract number.

II – No Updates to the Supplier Directory

Reversed logic for CBA and product category. User will now select Product Category(ies) and then the applicable CBA(s).

To provide efficiency for user to enter data (since there are more CBA options than product category options in each round).







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJoe
File Modified0000-00-00
File Created2021-01-29

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