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 from the Florida Department of Management Services (RFP No. DMS-24/25-312) detailing comprehensive reporting requirements for a Medicare Advantage and Prescription Drug (MA-PD) plan contract. The document outlines 22 distinct reports spanning weekly, monthly, quarterly, and annual frequencies, with specific due dates and formatting requirements. These reports include critical submissions such as Reject Records Reports, Duplicate Records Reports, Background Checks, Paid Claims Files, Performance Guarantee Reports, Formulary Changes, Utilization Reports, and Annual Plan Reports, all of which must be submitted in department-prescribed formats and within specified timeframes.
The reporting schedule is meticulously structured, with most reports requiring submission within 2-45 calendar days of the relevant period's end, depending on the report type. Notable requirements include weekly reports due within 2 business days of file availability, monthly reports typically due by the 15th of the following month, quarterly reports due within 45 calendar days of quarter-end, and annual reports like the Renewal Report due by May 1, 2028, and annually thereafter. Specific technical requirements include Excel format for Enrollee Invoices, data keys for CMS-related reports, and consistent adherence to department-prescribed formatting across most deliverables. The comprehensive reporting matrix ensures detailed tracking and transparency for the Medicare Advantage and Prescription Drug plan contract.
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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 .