Crosswalk

Attachment C
Paperwork Reduction Act Submission
OMB # 0938 – 0944
CMS-10142
Summary of Changes
The following revisions are in response to Lessons Learned feedback (from industry, contracted
bid reviewers and internal CMS) and contract year 2017 effective provisions of the Medicare
Advantage and Prescription Drug Program. They do not result in a change to the estimated
burden.
1) Updated labels/parameters: Annual update of labels/parameters (ex: CY2016 → CY2017).
Locations: PD Worksheet 1 cell N3, F5, C29:C31, B43
PD Worksheet 7 cell B9, C10:C12
MA Worksheet 1 cell Q3, D8
MA Worksheet 6 cell E14
MSA Worksheet 1 cell P3, D8
MSA Worksheet 4 cell H48, H53
ESRD-SNP Worksheet 1 cell B6, C1, I2, I3
ESRD-SNP Worksheet 2 cell E16:E19
Reason: Update BPT to reference Contract Year 2017 information.
2) Remove input cells.
Locations: MA Worksheet 3 cells B67:N67
PD Worksheet 2 cells E60:I67
Reason: To improve accuracy/clarity of BPT for CY2017.
3) Add input cells.
Locations: MA Worksheet 1 cells P7:Q7
MA Worksheet 3 cells R67:T68
MA Worksheet 4 cells J104:N111
PD Worksheet 1 cells L5 and L6
PD Worksheet 3 cells B50:H55
Reason: To improve accuracy/clarity of BPT for CY2017.
4) Revise labels.
Locations: MA Worksheet 1 cells L13, N13, P13, B31, B42, H24, and H25
MA Worksheet 2 cells C24, C35, G17, and G18
MA Worksheet 3 cells C30, C31, C53, D31, F20:F23, G20:K20, G66, J66, M66
MA Worksheet 4 cells C24, C53, C82, C35, C64, C93

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MA Worksheet 6 cell B50
MSA Worksheet 1 cells L13, N13, C31, H24, H25
MSA Worksheet 2 cells C24, G17, G18
MSA Worksheet 3 cell B23
PD Worksheet 1 cells K11, M11
PD Worksheet 7 cell B43
Reason: To improve accuracy/clarity of BPT for CY2017.

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