| Appendix 1: Data Validation Standards | 
	
		| 2010 (old version) | 2013 (new version) | Type of Change | Reason for Change | Burden Change | 
	
		| The following reporting sections underwent data validation in Part C:  Benefit Utilization, Procedure Frequency, Serious Reportable Adverse Events (SRAEs), Provider Network Adequacy, Grievances, Organization Determinations/Reconsiderations, Employer Group Plan Sponsors, Plan Oversight of Agents, and Special Needs Plan Care Managment (SNPs).  The following reporting sections underwent data validation in Part D: Retail, Home Infusion, and Long Term Care Pharmacy Access, Medication Therapy Management Programs (MTM), Grievances, Coverage Determinations and Exceptions, Appeals, Long-Term Care Utilization, Employer/Union Sponsored Group Health Plan Sponsors, and Plan Oversight of Agents.  Therefore, a total of 9 reporting sections in Part C underwent the data validation and 8 reporting sections in Part D underwent the data validation. | For 2013, the following Part C reporting sections will undergo data validation: SRAEs-2012 and 2013, Grievances, Organization Determinations/Reconsiderations, SNPs-2012 and 2013.  The following Part D reporting sections will undergo data validation: MTM, Grievances, Coverage Determinations and Exceptions, Redeterminations, and Long-Term Care Utilization. That is a total of 6 Part C reporting sections and 4 Part D reporting sections. | Rev | Reporting for a number of reporting sections was suspended between 2011 and 2014.  This was due to the information being available elsewhere or a decision not to data validate if the reporting section was used for monitoring only. | Reduction | 
	
		| The number of data elements for Part C grievances was 7.  The number of data elements for Part D grievances was 10. | The number of data elements for Part C grievances was 18, the same as Part D. | Rev | Users were of the opinion that more data elements were needed to adequately categrize types of grievances. | Increase. This was due to more standards being validated due to an increase in data elements. | 
	
		| The number of data elements for Coverage and Exceptions was 10. | The number of data elements is 28. | Rev. | Increase in data elements was needed to get better use out of this reporting section. | Increase. This was due to more standards being validated due to an increase in data elements. | 
	
		| Reporting section was called "Appeals". | "Appeals" was changed to "Redeterminations". | Rev. | This new term is more consistent with current usage. | None | 
	
		| Appeals had 3 data elements. | The number of data elements in Appeals increased from 3 to 12. | Rev. | Increase in data elements was needed to get better use out of this reporting section. | Increase. This was due to more standards being validated due to an increase in data elements. | 
	
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		| Appendix  5: Findings Data Collection Form | 
	
		| 2010 (old version) | 2013 (new version) | Type of Change | Reason for Change | Burden Change | 
	
		| "MSC" refers to "measure Specific Criteria." | "MSC" is replaced by "RSC" to refer to "Reporting Section Specific Criteria." | Rev. | To be consistent with term change that was adopted: "Measure" was replaced by "Reporting Section." | None | 
	
		| The following reporting sections underwent data validation in Part C:  Benefit Utilization, Procedure Frequency, Serious Reportable Adverse Events (SRAEs), Provider Network Adequacy, Grievances, Organization Determinations/Reconsiderations, Employer Group Plan Sponsors, Plan Oversight of Agents, and Special Needs Plan Care Management (SNPs).  The following reporting sections underwent data validation in Part D: Retail, Home Infusion, and Long Term Care Pharmacy Access, Medication Therapy Management Programs (MTM), Grievances, Coverage Determinations and Exceptions, Appeals, Long-Term Care Utilization, Employer/Union Sponsored Group Health Plan Sponsors, and Plan Oversight of Agents.  Therefore, a total of 9 reporting sections in Part C underwent the data validation and 8 reporting sections in Part D underwent the data validation. | For 2013, the following Part C reporting sections will undergo data validation: SRAEs-2012 and 2013, Grievances, Organization Determinations/Reconsiderations, SNPs-2012 and 2013.  The following Part D reporting sections will undergo data validation: MTM, Grievances, Coverage Determinations and Exceptions, Redeterminations, and Long-Term Care Utilization. That is a total of 6 Part C reporting sections and 4 Part D reporting sections. | Rev | Reporting for a number of reporting sections was suspended between 2011 and 2014.  This was due to the information being available elsewhere or a decision not to data validate if the reporting section was used for monitoring only. | Reduction | 
	
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