Supplemental Crosswalk (30-day Internal CMS Review)

Supplemental Crosswalk

Medicare Part C and Part D Data Validation for 2015-2017

CMS-10305 (OCN 0938-1115)

30-Day Package submitted to OMB on Sept 26, 2014	Revisions to Sept 26 submission	Reason for Change	Burden Change
Part C SNPs Care Management Reporting Section of the “Findings Data Collection Form” (Appendix5V5 FDCF.1029.2014.xlsx). For SNPs Care Management, Standard-Sub-Standard 2.e, RSC 4 on rows 69-74 and columns D-E requested scoring for the 4 data elements (13.1, 13.2, 13.3, 13.4). The text reads: “The number of expected counts (e.g., number of members, claims, grievances, procedures) are verified; ranges of data fields are verified; all calculations (e.g., derived data fields) are verified; missing data has been properly addressed; reporting output matches corresponding source documents (e.g., programming code, saved queries, analysis plans); version control of reported data elements is appropriately applied; QA checks/thresholds are applied to detect outlier or erroneous data prior to data submission.”	Deleted.	Deleted the data elements to be scored under 2.e reporting section criterion 4. Scoring should begin with 4a. The previous version was in error. This RSC should only have the data sources listed that were assessed under the subsequent RSC.	No

30-Day Package submitted to OMB on Sept 26, 2014	Revisions to Sept 26 submission	Reason for Change	Burden Change
The change is on page 11 of “Data Extraction and Sampling Instructions” (Appendix3 V5 110614.docx), exhibit 7 for both Part C and Part D Plan Oversight of Agents reporting sections. Recommended sampling procedures for the Plan Oversight of Agents reporting section need to include two samples (if sampling is needed): one for agents and one for beneficiaries.	If sampling is needed, a random sample of 150 agents should be selected using the Plan Assigned Agent/Broker Identification Number (Under “Agent/Broker” Data Elements A-R). For members, a random sample of 150 should be drawn using the Beneficiary HICN or RRB Number (Under “New Enrollments” Data Elements A-P). This is now reflected in exhibit 7 on page 11.	The previous sampling methodology only included sampling of agents.	No. In virtually all cases a sample should not be needed because the “universe” (census) would be available electronically.
This applies to page 2 of “Appendix 2: Organizational Assessment Instrument” (App 2 OrgAssessment_CMS_10305_V5 110614.docx). A change is needed regarding the timeline for SO submission of the Organizational Assessment Instrument and related documents/files to data validation reviewers.	We now state in Table 1: Timeline of OAI Activities that the Organizational Assessment Instrument (OAI) should be provided to the reviewer “No earlier than 30 days prior to the start of the DV cycle on April 1.” We also indicate to allow two weeks after receipt of the OAI for the analysis to be completed.	DV reviewers couldn’t get started on April 1 because they needed time to review the OAI and related documents.	No.

30-Day Package submitted to OMB on Sept 26, 2014	Revisions to Sept 26 submission	Reason for Change	Burden Change
For the Plan Oversight of Agents reporting section, both Part C and Part D: RSC-6k stated: “Includes Agent/Broker assisted enrollments that involve a beneficiary’s change from one plan benefit package to another within the same contract.” This was found on the “Findings Data Collection Form” (Appendix5V5 FDCF.1029.2014.xlsx), tabs for both Plan Oversight of Agents – Part C and Plan Oversight of Agents – Part D.	RSC-6k now states “Does not include [underline is ours] Agent/Broker assisted enrollments that involve a beneficiary’s change from one plan benefit package to another within the same contract.” This is now consistent with the technical specifications.	This RSC needed to be consistent with the technical specifications.	No.

30-Day Package submitted to OMB on Sept 26, 2014	Revisions to Sept 26 submission	Reason for Change	Burden Change
For Part D, Coverage and Determinations, of the “Findings Data Collection Form” (Appendix5V5 FDCF.1029.2014.xlsx). Revisions needed for RSC – 14a-c, RSC – 15c, RSC – 19c, and RSC – 20a and RSC – 21a. These RSCs are under the Part D, Coverage and Determinations tab.	RSC – 14a-c – Revised to include data element P. (FDCF) RSC – 15c revised to clarify that withdrawals and dismissals should not be included as a subset of total coverage determinations decisions. (DV Standards document) RSC – 19c revised to clarify that withdrawals and dismissals should not be included as a subset of total redeterminations decisions. (DV Standards document) RSC – 20a and RSC – 21a-i were added to account for reopenings data elements included in reporting. (DV Standard document, FDCF)	To be consistent with the technical specifications.	No

30-Day Package submitted to OMB on Sept 26, 2014	Revisions to Sept 26 submission	Reason for Change	Burden Change
Plan Oversight of Agents (POA): The change is on page 8-9 of “Data Extraction and Sampling Instructions” (Appendix3 V5 110614.docx), exhibit 7 for both Part C and Part D Plan Oversight of Agents reporting sections. Revision needed to POA to include Complaint data and Agent/broker testing and training data as source data.	Complaint data and Agent/broker testing and training data are added as examples of source data in “data Extraction and Sampling Instructions”.	To be consistent with the technical specifications.	No