Download:
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pdf2021 Approved Document
2024 60-Day Document
Type of
Change
Reason for Change
Burden Change
Part C Enrollment. Page 13, Data Element K. Of the total
reported in A, the number of enrollment transactions
submitted using the SEP Election Period Code “S” for
individuals affected by a contract nonrenewal, plan
termination, or service area reduction.
Deleted
Page 12 of the Part C Reporting Requirements currently
states Note: Both Chapter 2 of the Medicare Managed Care
Manual and Chapter 3 of the Medicare Prescription Drug
Manual outline the enrollment and disenrollment periods
(Section 30).
CMS provides guidance for MAOs and Part D sponsors’ processing Update
of enrollment and disenrollment requests. Both Chapter 2 of the
Medicare Managed Care Manual and Chapter 3 of the Medicare
Prescription Drug Manual outline the enrollment and disenrollment
periods (Section 30) enrollment (Section 40) and disenrollment
procedures (Section 50) for all Medicare health and prescription drug
plans
Consistent with Part C Technical Specifications.
None
None
Supplemental Benefits Reporting Section
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element A - PBP
Category
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element B New
Supplemental benefit name, if “Other” (13d, 13e, 13f, or 13i-O), or if
name otherwise differs from values provided above.
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element C - How is the New
supplemental benefit offered? (Mandatory (all enrollees eligible),
Optional, Mandatory-UF (only enrollees eligible for Uniformity
Flexibility), Mandatory-SSBCI (only enrollees eligible for SSBCI), not
offered)
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element D - The unit of
utilization used by the plan when measuring utilization (e.g.,
admissions, visits, procedures, trips, purchases).
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element E - The number New
of enrollees eligible for the benefit
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element F - The number New
of enrollees who utilized the benefit at least once
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element G - The total
instances of utilizations among eligible enrollees
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element H - The median New
number of utilizations among enrollees who utilized the benefit at
least once
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element I - The total
amount spent by plan for enrollees who utilized the benefit
New Part C Reporting Requirement
Increase
Update
New
Consistent with HPMS system requirements. Data now None
collected through MARx.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
None
Supplemental Benefits Reporting Section - Element J - The total out- New
of-pocket-cost per utilization for enrollees who utilized the benefit
New Part C Reporting Requirement
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Increase
2021 Approved Document
2024 30-Day Document
Type of
Change
Reason for Change
Burden Change
Part C Enrollment. Page 13, Data Element K. Of the total
reported in A, the number of enrollment transactions
submitted using the SEP Election Period Code “S” for
individuals affected by a contract nonrenewal, plan
termination, or service area reduction.
Deleted
Page 12 of the Part C Reporting Requirements currently
states Note: Both Chapter 2 of the Medicare Managed Care
Manual and Chapter 3 of the Medicare Prescription Drug
Manual outline the enrollment and disenrollment periods
(Section 30).
CMS provides guidance for MAOs and Part D sponsors’ processing Update
of enrollment and disenrollment requests. Both Chapter 2 of the
Medicare Managed Care Manual and Chapter 3 of the Medicare
Prescription Drug Manual outline the enrollment and disenrollment
periods (Section 30) enrollment (Section 40) and disenrollment
procedures (Section 50) for all Medicare health and prescription drug
plans
Consistent with Part C Technical Specifications.
None
None
Supplemental Benefits Reporting Section
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element A - PBP
Category
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element B New
Supplemental benefit name, if “Other” (13d, 13e, 13f, or 13i-O), or if
name otherwise differs from values provided above.
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element C - How is the New
supplemental benefit offered? (Mandatory (all enrollees eligible),
Optional, Mandatory-UF (only enrollees eligible for Uniformity
Flexibility), Mandatory-SSBCI (only enrollees eligible for SSBCI), not
offered)
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element D - The unit of
utilization used by the plan when measuring utilization (e.g.,
admissions, visits, procedures, trips, purchases).
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element E - The number New
of enrollees eligible for the benefit
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element F - The number New
of enrollees who utilized the benefit at least once
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element G - The total
instances of utilizations among eligible enrollees
New
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element H - The median New
number of utilizations among enrollees who utilized the benefit at
least once
New Part C Reporting Requirement
Increase
None
Supplemental Benefits Reporting Section - Element I - The total net New
amount incurred by plan to offer the benefit.
New Part C Reporting Requirement
Increase
Update
Consistent with HPMS system requirements. Data now None
collected through MARx.
None
None
None
Supplemental Benefits Reporting Section - Element J - The type of New
payment arrangement(s) the plan used to implement the benefit. The
plan may use the categories CMS provides in the Payments to
Providers section of the Part C Reporting Requirements.
Alternatively, the plan may use other phrases or provide a brief
Supplemental Benefits Reporting Section - Element K - How the plan New
accounts for the cost of the benefit, including how the plan
determines and measures administrative costs, costs to deliver, and
any other costs the plan captures.
New Part C Reporting Requirement
Increase
New Part C Reporting Requirement
Increase
Supplemental Benefits Reporting Section - Element L - The total out- New
of-pocket-cost per utilization for enrollees who utilized the benefit
New Part C Reporting Requirement
Increase
| File Type | application/pdf |
| File Title | Medicare Part C and Part D CY2021 to CY2024 Crosswalk |
| Subject | Data Validation Crosswalk |
| Author | Centers for Medicare and Medicaid Services |
| File Modified | 2023-09-20 |
| File Created | 2023-09-20 |