Crosswalk: Technical Specifications Document

Crosswalk_PartC_2017_18_60_day_CMS10261.docx

Part C Medicare Advantage Reporting Requirements and Supporting Regulations in 42 CFR 422.516(a) (CMS-10261)

Crosswalk: Technical Specifications Document

OMB: 0938-1054

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Crosswalk of Changes Part C Reporting Requirements—60 day comments and responses

(Part C Reporting Requirements CMS-10261; OMB 0938-1054) August 2016


Initial Version

60-Day Revision

Type of Change

Reason for Change

Burden Change

Listed 5 new data elements for Organization Determinations/Reconsiderations Reporting Section (ODR)

Only 4 new data elements listed for ODR

Revision

Recognized there were only four new data elements for ODR due to comment

Decrease from initial ICR

Reporting requirements lacked some specificity about reporting of terminations.

Revisions to the Mid-Year Network Changes section (16) of the CY 2017 Part C reporting requirements tech specs. MAOs are to report on both for-cause and no-cause terminations, as well as both MAO-initiated and provider-initiated terminations.

Revision

Instructions for reporting needed clarification.

None.

Initial Version

60-Day Revision

Type of Change

Reason for Change

Burden Change

Payments to Providers reporting section had 10 data elements which did not adequately distinguish between payments made based on provider quality and payments not based on quality.

Four new data elements were added that enabled a distinction between payments made based on quality and other payments.

Revision

Need to get more data on payments based on quality

Increase

One of the reporting sections included in the Part C Reporting Requirements was Sponsor Oversight of Agents.

Sponsor Oversight of Agents Reporting Section is suspended for 2017 reporting.

Revision

Need to determine the utility of this reporting section and whether the information it provides is sufficient given the required resources for collection and reporting.

Decrease

Initial Version

60-Day Revision

Type of Change

Reason for Change

Burden Change

Enrollment/Disenrollment Reporting Section includes Data Elements 1-M and 1-N.

  • Of the number reported in A, the number of enrollment transactions submitted using the SEP Election Period code "S" related to SPAP. (This does not apply to Part C or 1876 Cost Plans.) *

  • For stand-alone prescription drug plans (PDPs) only: Of the number reported in A, the number of enrollment transactions submitted using the SEP Election Period code “S” related to SPAP (This does not apply to Part C or 1876 Cost Plans.) *



Data elements 1-M and 1-N need to be removed from Enrollment/Disenrollment Reporting Section

Revision

These data elements no longer apply.

Decrease.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorTerry Lied
File Modified0000-00-00
File Created2021-01-23

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