| 2015 (old version) |
2016 (new version) |
Type of Change |
Reason for Change |
Burden Change |
| Enrollment: 1 A: The total number of enrollment requests received in the specified time period. |
Enrollment: 1 A: The total number of enrollment requests (i.e., requests initiated by the beneficiary or his/her authorized representative) received in the specified time period. Do not include auto/facilitated or passive enrollments, rollover transactions or other enrollments effectuated by CMS. |
Rev |
Provided technical clarification. |
No |
| Enrollment: 1 I: Of the total reported in A, the number of internet enrollment requests received via plan website (if Sponsor offers this mechanism). |
Enrollment: 1 I: Of the total reported in A, the number of internet enrollment requests received via plan or affiliated third-party website (if Sponsor offers this mechanism). |
Rev |
Provide technical clarification. |
No |
| Disenrollment: 2 A:The total number of voluntary disenrollment requests received in the specified time period. |
Disenrollment: 2 A: The total number of voluntary disenrollment requests received in the specified time period. Do not include disenrollments resulting from an individual’s enrollment in another plan. |
Rev |
Provide technical clarification. |
No |
| N/A |
Disenrollment: 2 D: The total number of involuntary disenrollments for failure to pay plan premium in the specified time period. |
Add |
Revise data collection necessary for monitoring purposes. |
No |
| N/A |
Disenrollment: 2 E: Of the total reported in D, the number of disenrolled individuals who submitted a timely request for reinstatement for Good Cause. |
Add |
Revise data collection necessary for monitoring purposes. |
No |
| N/A |
Disenrollment: 2 F: Of the total reported in E, the number of favorable Good Cause determinations. |
Add |
Revise data collection necessary for monitoring purposes. |
No |
| N/A |
Disenrollment: 2 G: Of the total reported in F, the number of individuals reinstated. |
Add |
Revise data collection necessary for monitoring purposes. |
No |
| MTM: Q: Date(s) of CMR(s) with written summary in CMS standardized format. (If more than 1 CMR is received, up to 5 dates will be allowed.) Required if received annual CMR. |
MTM: Q: Date(s) of CMR(s) with written summary in CMS standardized format. (If more than 1 CMR is received, up to 2 dates will be allowed.) Required if received annual CMR. |
Rev |
After analyzing the data it was concluded that only 2 dates are needed for monitoring purposes. |
No |
| MTM: S: Qualified Provider who performed the initial CMR. (Physician; Registered Nurse; Licensed Practical Nurse; Nurse Practitioner; Physician’s Assistant; Local Pharmacist; LTC Consultant Pharmacist; Plan Sponsor Pharmacist; Plan Benefit Manager (PBM) Pharmacist; MTM Vendor Local Pharmacist; MTM Vendor In-house Pharmacist; Hospital Pharmacist; Pharmacist – Other; or Other). Required if received annual CMR. |
MTM: S: Qualified Provider who performed the initial CMR. (Physician; Registered Nurse; Licensed Practical Nurse; Nurse Practitioner; Physician’s Assistant; Local Pharmacist; LTC Consultant Pharmacist; Plan Sponsor Pharmacist; Plan Benefit Manager (PBM) Pharmacist; MTM Vendor Local Pharmacist; MTM Vendor In-house Pharmacist; Hospital Pharmacist; Pharmacist – Other; Supervised Pharmacy Intern; or Other). Required if received annual CMR. |
Rev |
Provide technical clarification. |
No |
| Prompt Payment by Part D Sponsors |
Prompt Payment by Part D Sponsors |
Del |
The data collection is no longer necessary for monitoring purposes. |
No |
| Long-Term Care (LTC) Utilization: C: The total number of beneficiaries in LTC facilities for whom Part D drugs have been provided under the Contract. |
Long-Term Care (LTC) Utilization: C: The total number of beneficiaries in LTC facilities for whom Part D drugs have been provided under the CMS Contract. |
Rev |
Provide technical clarification. |
No |
| Fraud, Waste and Abuse Compliance Program |
Fraud, Waste and Abuse Compliance Program |
Del |
The data collection is no longer necessary for monitoring purposes. |
No |
| Plan Oversight of Agents |
Plan Oversight of Agents |
Rev |
Increased hours. Data collection needed to increase for monitoring purposes. No new data added. |
Yes, because additional data is needed for monitoring purposes. |
| 2015 (old version) |
2016 (new version) |
Type of Change |
Reason for Change |
Burden Change |
| Long-Term Care (LTC) Utilization |
Long-Term Care (LTC) Utilization |
Del |
The data collection is no longer necessary for monitoring purposes. |
Yes-Reduces Burden |
| Plan Oversight of Agents |
Sponsor Oversight of Agents |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 F: Agent/Broker State Licensed. For agents licensed in multiple states, complete a row for each state in which the agent is licensed. |
Sponsor Oversight of Agents: 1 F: Agent/Broker State Licensed. For agents licensed in multiple states, complete a row for each state in which the agent is licensed if they also earned compensation in that state. |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 H: Plan Assigned Agent/Broker Identification Number |
Sponsor Oversight of Agents: 1 H: Sponsor Assigned Agent/Broker Identification Number |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 I: Agent/Broker Current License Effective Date. |
Sponsor Oversight of Agents: 1 I: Agent/Broker Current License Effective/Renewal Date (if applicable). |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 J: Agent/Broker Appointment Date. |
Sponsor Oversight of Agents: 1 J: Agent/Broker Appointment Date (if applicable). This date should be the most recent date the agent becomes affiliated with the sponsor. |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 K: Agent/Broker Training Completion Date |
Sponsor Oversight of Agents: 1 K: Agent/Broker Training Completion Date for the previous calendar year products. (Ex. If the current year is 2016 it would be CY2015 products, etc.) |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 1 L: Agent/Broker Testing Completion Date |
Sponsor Oversight of Agents: 1 L: Agent/Broker Testing Completion Date for the previous year products.. (Ex. If the current year is 2016 it would be CY2015 products, etc.) |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 2 K: Plan Assigned Agent/Broker Identification Number. |
Sponsor Oversight of Agents: 2 K: Sponsor Assigned Agent/Broker Identification Number. |
Rev |
Provide technical clarification. |
No |
| Sponsor Oversight of Agents: 2 L: Enrollment Mechanism. (Plan/Plan Representative Online; CMS Online Enrollment Center; Plan Call Center; 1-800-MEDICARE; Paper Application; Auto-Assigned/Facilitated; Other). |
Sponsor Oversight of Agents: 2 L: Enrollment Mechanism. (Sponsor/Sponsor Representative Online; CMS Online Enrollment Center; Sponsor Call Center; 1-800-MEDICARE; Paper Application; Auto-Assigned/Facilitated; Other). |
Rev |
Provide technical clarification. |
No |
| General Change: Reporting Deadlines had specific dates. |
General Change: Staggered deadlines and avoided specific dates. |
Rev |
Decrease system overload, decrease user response time. |
No |
| Enrollment and Disenrollment Reporting Timeline: Data due to CMS/HPMS: August 31 and February 28 |
Enrollment and Disenrollment Reporting Timeline: Data due to CMS/HPMS: Last Monday of August and Last Monday of February |
Rev |
Decrease system overload, decrease user response time. |
No |
| Retail, Home Infusion, and Long-Term Care Pharmacy Access Reporting Timeline (Section 1 only): Data due to CMS/HPMS: May 31 |
Retail, Home Infusion, and Long-Term Care Pharmacy Access Reporting Timeline (Seciton 1 only): Data due to CMS/HPMS: First Monday of May |
Rev |
Decrease system overload, decrease user response time. |
No |
| Retail, Home Infusion, and Long-Term Care Pharmacy Access Reporting Timeline (Sections 2 & 3 only): Data due to CMS/HPMS: February 28 |
Retail, Home Infusion, and Long-Term Care Pharmacy Access Reporting Timeline (Sections 2 & 3 only): Data due to CMS/HPMS: First Monday of February |
Rev |
Decrease system overload, decrease user response time. |
No |
| Medication Therapy Management Reporting Timeline: Data due to CMS/HPMS: February 28 |
Medication Therapy Management Reporting Timeline: Data due to CMS/HPMS: First Monday of February |
Rev |
Decrease system overload, decrease user response time. |
No |
| Grievances Reporting Timeline: Data due to CMS/HPMS: February 28 (reporting for all quarters due on this date) |
Grievances Reporting Timeline: Data due to CMS/HPMS: First Monday of February (reporting for all quarters due on this date) |
Rev |
Decrease system overload, decrease user response time. |
No |
| Coverage Determinations and Redeterminations Reporting Timeline: Data due to CMS/HPMS: February 28 (reporting for all quarters due on this date) |
Coverage Determinations and Redeterminations Reporting Timeline: Data due to CMS/HPMS: Last Monday of February (reporting for all quarters due on this date) |
Rev |
Decrease system overload, decrease user response time. |
No |
| Employer/Union-Sponsored Group Health Plan Sponsors Reporting Timeline: Data due to CMS/HPMS: February 28 |
Employer/Union-Sponsored Group Health Plan Sponsors Reporting Timeline: Data due to CMS/HPMS: First Monday of February |
Rev |
Decrease system overload, decrease user response time. |
No |
| Plan Oversight of Agents Reporting Timeline: Data due to CMS/HPMS: February 28 |
Sponsor Oversight of Agents Reporting Timeline: Data due to CMS/HPMS: First Monday of February |
Rev |
Decrease system overload, decrease user response time. |
No |