6. Attachment E - Reporting and Deliverables.pdf
PDF 94 KB Posted
- Attached to
- RFP No. DMS-2425-312 MAPD
- Solicitation number
- RFP-12976
- Issued by
- Leon County, Florida
About this file
Attachment E is a Reporting and Deliverables document for the Florida Department of Management Services (DMS) Request for Proposal (RFP) No. DMS-24/25-312 for Medicare Advantage and Prescription Drug plans. The document outlines 22 specific reporting requirements across weekly, monthly, quarterly, and annual frequencies, detailing the types of reports, their due dates, and required file formats. These reports include operational submissions such as Reject Records Reports, Paid Claims Files, Performance Guarantee Reports, Formulary Changes, Network Provider Add/Delete Reports, Medicare Membership Reports, and Annual Plan Reports, with most requiring submission within 2-45 calendar days of the relevant period's end.
The reporting requirements are comprehensive and structured to provide the state with detailed insights into plan performance, membership, claims, clinical programs, and operational metrics. Most reports must be submitted in a department-prescribed format, with some specific requirements like the Enrollee Invoice needing an Excel format with multiple tabs showing enrollment and invoiced amount details. Certain reports, such as the Part C and Part D Medicare reports, are to be submitted as received from CMS with a data key provided as needed. The reporting schedule spans from weekly operational tracking to annual strategic reviews, with critical dates including monthly submissions by the 15th, quarterly reports within 45 calendar days of quarter-end, and annual reports due by May 1st or within 45-60 calendar days of the year's end.
View the file
Other files
Show 40 more
50 files listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
RFP No.: DMS-24/25-312 Attachment E: Reporting and Deliverables Page 1 of 3
ATTACHMENT E: REPORTING AND DELIVERABLES
FREQUENCY REPORT
NUMBER REPORT NAME DUE DATE FILE LAYOUT
Weekly 1 Reject Records Report w/in 2 Business
Days starting w/ 1st full day file is available
Department-prescribed format.
2 Duplicate Records Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
3 Address Errors Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
4 System Generated Subscriber Drop Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
Monthly 5 Background
Checks/Persons with Disqualifying Offenses
15th of following month
6 Paid Claims File - to Dept/HIMIS
7 Paid Claims Summary Report
8 Part C and Part D Medicare Membership report (MMR) w/in 15 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
Attachment E: Reporting and Deliverables Page 2 of 3
9 Enrollee Invoice 15th of following month
Excel format, tab 1. Must include enrollment file Member detail matching invoiced amount on subsequent tab(s)
Quarterly
10 Performance Guarantee Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
11 Formulary Changes w/in 45 Calendar Days of quarter end
Department-prescribed format.
12 Key Metric Cost w/in 45 Calendar Days of quarter end
Department-prescribed format.
13 Utilizatin Report w/in 45 Calendar Days of quarter end
14 Trend Analysis Report w/in 45 Calendar end
Department-prescribed format.
15 Network Provider Add / Delete Report w/in 45 Calendar
16 Trend Analysis Report w/in 45 Calendar
17 Clinical Program Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
Annually 18 Renewal Report May 1, 2028, and annually thereafter Department-prescribed format.
19 Participant Member
Satisfaction Survey Report w/in 45 Calendar Days of year end
19 Performance Bond By December 31 of each Plan Year
Attachment E: Reporting and Deliverables Page 3 of 3
20 Insurance Certificates By December 31 of each Plan Year
21 Part C and Part D Model Output Report
(MOR)
w/in 45 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
22 Annual Plan Report within 60 Calendar Days of the end of the Plan reporting year
File details come from the government source that posted it. Updated .