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 2018 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: CY2017 → CY2018).
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 2018 information.
2) Remove input cells.
Locations: MA Worksheet 1 cells P8:Q8
MA Worksheet 1 cells L67:P67
MA Worksheet 4 C96:R96, O114:R117
Reason: To improve accuracy/clarity of BPT for CY2018. Cells on WS4 removed for Employer
Group Bids no longer submitting BPTs.
5) Add input cells.
Locations: ESRD-SNP Worksheet 2 A48, D48, E47:E50, G47:G50, D70:D71, E70:E71
ESRD-SNP Worksheet 3 A59:A60, G59:G60

Reason: To improve accuracy/clarity of BPT for CY2018.
6) Revise labels.
Locations: MA Worksheet 4 O120
ESRD-SNP Worksheet 2 cells A3, A11, E11, A14, D15, G13:G15, A32, A38, E32,
E34:E38, E40, A42, E43, A54, D54, A61, A62
ESRD-SNP Worksheet 3 cells A27, A54, A63, B22

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Reason: To improve accuracy/clarity of BPT for CY2018.

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