On December 12, 2017, the Centers for Medicare and Medicaid Services (CMS) released a memo announcing that they would once again be conducting an industry-wide monitoring project to evaluate the timeliness of processing of Medicare Advantage (Part C) organization determinations and reconsiderations and Medicare Prescription Drug (Part D) coverage determinations and redeterminations. Plans will be required to submit applicable universes with data from March through May 2017, dependent upon their total enrollment.
The data will be collected in three waves, and plans can expect to receive notices and data requests as early as January 2018. Exempt from this requirement are plans who underwent a 2017 Program Audit without any Invalid Data Submission (IDS) conditions and had at least one month of 2017 data for each of the universes.
