Appendix B DV Crosswalk_Post 30-Day

CY 2022 DV (2021 Reporting Requirements)

CY 2023 DV (2022 Reporting Requirements)

Type of
Change
No Data

Part D: Improving Drug Utilization Review
Controls
RSC-6-aiii: Rejected opioid claims are counted at
the unique plan, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, date of
service (DOS), and formulary-level opioid MME POS
edit.
RSC-6-aiv: Properly counts the number of unique
beneficiaries by plan that triggered the care
coordination safety edit and, if applicable, a provider
and/or pharmacy criterion.

No Data

RSC-6-biii: Rejected opioid claims are counted at
the unique plan, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, DOS, and
formulary-level opioid MME POS edit.

RSC-6-biii: Rejected opioid claims are counted at the
unique contract, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, DOS, and
formulary-level opioid MME POS edit.

RSC-6-biv: Properly counts the number of unique
beneficiaries by plan that triggered the established
hard MME safety edit threshold and, if applicable, a
provider and/or pharmacy criterion.

RSC-6-biv: Properly counts the number of unique
beneficiaries by contract that triggered the
established hard MME safety edit threshold and, if
applicable, a provider and/or pharmacy criterion.

RSC-6-ciii: Rejected opioid claims are counted at
the unique plan, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, and
DOS.

RSC-6-ciii: Rejected opioid claims are counted at the
unique contract, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, and DOS.

Update

RSC-6-civ: Properly counts the number of unique
beneficiaries by plan that triggered the opioid naïve
days supply safety edit.

RSC-6-civ: Properly counts the number of unique
beneficiaries by contract that triggered the opioid
naïve days supply safety edit.

Update

RSC-7-b: Properly identifies and counts the number
of unique beneficiaries per plan with at least one
claim rejection due to its care coordination safety
POS edit and a pharmacist overridden care
coordination safety POS edit rejected claim.

RSC-7-b: Properly identifies and counts the number
of unique beneficiaries per contract with at least one
claim rejection due to its care coordination safety
POS edit and a pharmacist overridden care
coordination safety POS edit rejected claim.

Part D: Medication Therapy Management
Program

No Data

RSC-6-aiii: Rejected opioid claims are counted at the
unique contract, beneficiary, prescriber, pharmacy,
drug (strength and dosage form), quantity, date of
service (DOS), and formulary-level opioid MME POS
edit.
RSC-6-aiv: Properly counts the number of unique
beneficiaries by contract that triggered the care
coordination safety edit and, if applicable, a provider
and/or pharmacy criterion.

Reason for
Change
No Data

Burden
Change
No Data

Update

Consistent with
current
technical
guidance

None

Update

Consistent with
current
technical
guidance

None

Update

Consistent with
current
technical
guidance

None

Update

Consistent with
current
technical
guidance

None

Update

No Data

Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance

No Data

None

None

None

No Data

CY 2022 DV (2021 Reporting Requirements)

CY 2023 DV (2022 Reporting Requirements)

RSC-5.s: If a CMR was not received (Data Element
O = No), there are no reported delivery date(s) (Data
Element Q = missing) unless the CMR summary
Deleted
was returned via mail, then the reported delivery
date should be the date that the written summary
was sent (Data Element Q ≠ missing).

Type of
Change

Reason for
Change

Burden
Change

Deletion

Consistent with
current
technical
guidance

None

RSC-5.t

Changed numbering to RSC-5.s

Update

RSC-5.u

Changed numbering to RSC-5.t

Update

RSC-5.v

Changed numbering to RSC-5.u

Update

RSC-5.w

Changed numbering to RSC-5.v

Update

RSC-5.x

Changed numbering to RSC-5.w

Update

RSC-5.y

Changed numbering to RSC-5.x

Update

RSC-5.z

Changed numbering to RSC-5.y

Update

Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance
Consistent with
current
technical
guidance

None

None

None

None

None

None

None

CY 2022 DV (2021 Reporting Requirements)

CY 2023 DV (2022 Reporting Requirements)

Type of
Change

RSC-5.aa

Changed numbering to RSC-5.z

Update

RSC-5.bb

Changed numbering to RSC-5.aa

Update

RSC-5.cc

Changed numbering to RSC-5.bb

Update

Reason for
Change
Consistent with
current
technical
guidance
Consistent with
current
Consistent with
current

Burden
Change
None
None
None