Are you ready for CMS universe testing for this fall’s Timeliness Monitoring Project (TMP) project? Are you ready for a CMS program audit?
CMS will perform the yearly Timeliness Monitoring Project in three waves of data requests beginning in September 2022 and ending in October 2022. This will be the first year testing the new universes from 2022 audit protocols, and CMS emphasizes that plans should be ready with new universe layouts.
It’s time to consider the following:
· Has your organization accounted for Part B drug changes in Tables 1, 2, and 4, both standard and expedited, including extension differences for Part B drugs?
· Has your organization implemented and tested notification changes related to D-SNP AIP plans for Tables 1-4?
· For Table 3 payment organization determinations, are you applying the correct timeliness standard for both D-SNP AIPs and Non-AIP D-SNPs? Have you stopped testing elements CMS no longer tests?
These are just a few of the protocol changes that all plans should be ready to demonstrate to CMS in their data for the TMP project and any future CMS program audits.
Key items to know now:
· Only sponsors that have contracts in both CY 2022 and CY 2023 need to submit 2022 data to CMS.
· Sponsors that undergo a 2022 program audit will not have to resubmit data if they successfully submitted requested ODAG universes with no Invalid Data Submission (IDS) conditions. Check your draft audit report.
· Sponsors currently undergoing a program audit are not exempt from this project.
· All standalone Prescription Drug Plan, Program of All-Inclusive Care for the Elderly, Medicare-Medicaid Plan, Medicare Medical Savings Account, Employer/Union Only Direct (“E” contracts), and 1833 Health Care Prepayment Plan contracts are excluded from this data submissions.
· Email CMSProgramAudits@mslc.com by July 25, 2022 and provide details regarding your organization’s SFTP access.
· Send questions regarding data collection for this monitoring project to TimelinessMonitoring@cms.hhs.gov.
Contact ATTAC to test your universes now, before you get a request from CMS. We have tested 2022 protocol universes since October 2021 with plans of all sizes. And although the TMP is limited to universe Table 2 pre-service reconsiderations and the payment reconsiderations element in Table 3, we are ready to test all six universes. And if you need testing for only the TMP universes, we can do that, too.