NADAC Survey Tool: Crosswalk

0938-1041 Survey of Retail Prices (CMS-10241) Survey Crosswalk_508_.xlsx

Survey of Retail Prices (CMS-10241)

NADAC Survey Tool: Crosswalk

OMB: 0938-1041

Document [xlsx]
Download: xlsx | pdf
# Form Change Current Location Reason
7 NADAC Survey Letter Translate to Spanish Survey Tool For use in Puerto Rico
8 NADAC Survey Letter Change Date from January 1, 2023 to open field to add date Top of Letter To reflect the actual date the letter will be sent monthly
9 NADAC Survey Letter Add word "pricing" before resource First paragraph, first sentence To clarify the NADAC benchmark is a pricing resource
10 NADAC Survey Letter Change "perform the survey process" to "conduct a pricing survey" First paragraph, second sentence Verbiage clarity
11 NADAC Survey Letter Remove second paragraph beginning "Each month, CMS sends surveys…" Second paragraph Determined not necessary to repeat with each letter since survey process has been ongoing for some time
12 NADAC Survey Letter Remove sentence beginning "One of the primary goals of the survey…" Third paragraph, second sentence Simplify paragraph
13 NADAC Survey Letter Remove sentence beginning "As your pharmacy has been selected…" Third paragraph, last sentence Determined not necessary to repeat with each letter since survey process has been ongoing for some time
14 NADAC Survey Letter Add word "calendar" before "days" Fourth paragraph Verbiage clarity
15 NADAC Survey Letter Change December 1, 2022 and December 31, 2022 to open field to add date Blue box To reflect the actual date range each month
16 NADAC Survey Letter Remove sentence beginning "These records are to be limited to…" First paragraph below blue box Determined not necessary to repeat with each letter since survey process has been ongoing for some time
17 NADAC Survey Letter Add numbers to list information to be submitted List below blue box Formatting for clarity
18 NADAC Survey Letter Add "Labeler Name/Product Name" to list of information to be submitted List below blue box Required information needed for collection of survey data
19 NADAC Survey Letter Replace line beginning with "Item Number..." from list of information to adding it below with the sentence beginning "If the invoice provided only contains…" List below blue box Edited for clarity
20 NADAC Survey Letter Revise sentence beginning "Information should be mailed..," to "Information should be emailed, mailed…" eliminating the language "sent electronically" Bold sentence on second page Edited for clarity
21 NADAC Survey Letter Change "14 days" to "10 calendar days" Bold sentence on second page To clarify the response time
22 NADAC Survey Letter Move Email line to top of chart Chart underneath bold sentence on second page Formatting to show email as primary method for sharing
23 NADAC Survey Letter Move sentence beginning "Please contact the NADAC Help Desk…" to new paragraph below URLs Second paragraph below chart on second page Formatting
24 NADAC Survey Letter Remove "information regarding" Second sentence in second paragraph below chart on second page Edited for clarity
25 NADAC Survey Letter Replace "http://www.Medicaid.gov)" with "at the links provided below." Second sentence in second paragraph below chart on second page Multiple URLs are included as resources instead of generic Medicaid.gov site
26 NADAC Survey Letter Add URLs for "NADAC reference file" and "Confidentiality Statement" Below second paragraph below chart on second page Multiple URLs are included as resources instead of generic Medicaid.gov site
27 NADAC Survey Letter Replace "Disabled and Elderly" with "Medicaid Benefits and" Signature block Group name changed from Disabled and Elderly Health Programs Group to Medicaid Benefits and Health Programs Group
28 NADAC Survey Letter Update PRA Disclosure Statement PRA Disclosure Statement Per OSORA instruction
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