CMS-10811 CMS-10811. Appendix B_Part D Survey Questions FINAL

Appendix D

Medicare Part D Questions
Contract number:
Contract Name:
Parent Org:
Respondent name:
Respondent role:
The purpose of this survey is to collect feedback from Medicare Part D sponsors selected for improper payment
validation. This survey will be used to solicit feedback on CMS outreach, training, and resource materials to
determine any areas to enhance or adjust.

Training and Communications Documents
1. Did your organization attend the Calendar Year 2020 Medicare Part D Improper Payment Measure
Training Teleconference, held on Wednesday, January 26, 2022?
(radio button options)
o
o

Yes
No

2. Was the information presented at the Calendar Year 2020 Medicare Part D Improper Payment
Measure Training Teleconference helpful? Please include any suggestions for future conferences in
the comment box.
(radio button options)
o
o
o
o

Helpful
Somewhat helpful
Not helpful
N/A – Did not attend

Comment Box – Suggestions for other topics to include in the conference.

3. Did you find the conference to be effective and suit your organizations’ needs? Would you prefer an
on-demand training that is recorded and available at your convenience or do you prefer the live
event?
(radio button options)
o
o
o

On-demand training
Live event
Other – Please provide comment

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Appendix D

Medicare Part D Questions
4. Of the following documents available in the Part D IPM document library, select the documents you
find useful during the submission process?
(multiple select box options)
o
o
o
o
o
o
o
o
o
o
o
o

Part D IPM Frequently Asked Questions
Part D IPM LTC Submission Reference Sheet
Part D IPM LTC Attestation Form Instructions
Part D IPM LTC Physician Attestation Form
Part D IPM Missing Documentation Form
Part D IPM Submission Instructions
CY 2020 Part D IPM Training Teleconference Slides
CY 2020 Part D IPM Training Teleconference Training Recording
CY 2020 Part D IPM Training HPMS Demonstration
Part D Improper Payment Measure – Podcasts
All of the above
None of the above

5. Are the Submission Instructions provided during the Part D IPM review helpful in answering questions
regarding the document submission process?
(radio button options)
o
o
o

Helpful
Somewhat helpful
Not helpful

6. Did the notifications received from the Part D IPM module provide adequate details about required
activities, submission timelines, and upcoming deadlines? If not, please provide details.
(radio button options)
o
o
o

Yes
Somewhat
Not at all

7. What other information would you find helpful in Part D IPM communications? Please share
ideas/recommendations for improving the quality and delivery method for communications related to
the Part D IPM activity.

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Appendix D

Medicare Part D Questions
Part D Feedback and Finding Reports
1. Did you find the feedback provided in the upload status check immediately upon document
submission helpful?
(radio button options)
o
o
o
o

Helpful
Somewhat helpful
Not helpful
Unaware immediate feedback was provided

2. If yes, did you find this helpful in correcting any identified issues?
o
Yes
o
Somewhat
o
Not at all

3. Did you find the Final Finding Report (FFR) useful? What content would you suggest adding?
(radio button options)
o
o

Yes
No

Comment Box – What additional detail would you find useful in the FFR?

4. What, if any, action did you take based on the feedback provided for your selected Prescription Drug
Event (PDE) records on your FFR?
Comment Box – What actions did you take based on feedback provided?

HPMS Navigation and Documentation Submission
1. How easy was it to locate your contract’s Claim Detail File (CDF) Template?
(radio button options)
o

Difficult
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Appendix D

Medicare Part D Questions
o
o

Neutral
Easy

2. How easy was it to submit supporting documentation?
(radio button options)
o
o
o

Difficult
Neutral
Easy

3. Did you find the communications through the HPMS Discussion Board to assist in your documentation
submission or clearing issues?
o
o
o
o

N/A – My organization did not communicate through the Discussion Board
Helpful
Neutral
Not Helpful

4. How easy is it to access reports and reference documents within the Document Library from HPMS?
For example, Final Findings reports or submission instructions.
(radio button options)
o
o
o

Difficult
Neutral
Easy

5. Please provide any other feedback on the navigation through HPMS or templates for Part D IPM (such
as CDF).

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