Non-substantive change request memo

To: Jamie Wilson

Office of Information and Regulatory Affairs (OIRA)

Office of Management and Budget (OMB)

From: Sharon Winchester

Division of Encounter Data and Risk Adjustment Operations (DEDRAO), Medicare Plan Payment Group (MPPG), Center for Medicare (CM)

Centers for Medicare & Medicaid Services (CMS)

Date: December 11, 2024

Subject: Non-Substantive Change Request – Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations

CMS-10340, (OMB# 0938-1152)

This memo requests approval of non-substantive changes to the approved information collection, Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations CMS-10340 (OMB# 0938-1152).

Background

In July 2024, OMB approved a revision of a currently approved information collection request for the Centers for Medicare & Medicaid Services (CMS). As a result of Inflation Reduction Act, CMS now requires an update to two forms within the PRA package that are completed (if applicable) during the process to obtain security credentials. One new dataset name is being requested from Medicare Part D and Medicare-Medicaid Plans (MMPs) and dataset lengths noted on the form are being corrected. This request represents those changes.

Overview of Requested Changes

Connect:Direct forms are part of the package of documents that organizations submit to obtain security credentials, which allows Medicare Advantage, Part D organizations, 1976 Cost Plans, MMPs, and Program of All-inclusive Care for the Elderly (PACE) organizations to submit Part C and D data to CMS. The Connect:Direct form is completed only by organizations who use Connect:Direct as the mode for transmitting data to and receiving data from CMS. The package of documents completed by organizations to obtain security access credentials was part of the PRA package that was approved in July 2024.

As a result of the Inflation Reduction Act and the expansion of the Prescription Drug Event (PDE) record layout used by Part D organizations to submit drug information to CMS, updates are necessary to the month end reports delivered to Part D organizations. Specifically, there is a new report that will be issued monthly by CMS to Part D organizations and MMPs that provides cumulative beneficiary summary information beginning with dates of service in 2025. The creation of this new report requires an update to the Connect:Direct forms for Part D and MMP organizations to allow these organizations to provide the information necessary to receive the new report. Specifically, Part D and MMP organizations will need to provide a new dataset name in the Connect:Direct form so that they can receive the new Part D report, called DDPS 25 Cumulative Beneficiary Summary.

Additionally, this non-substantive change request includes updating references to dataset lengths that appear on the current Connect:Direct form.

Time Sensitivities

The PRA package needs to receive final approval by February 1, 2025 so that CMS can begin distributing the report to Part D and MMP organizations.