Exibit_B_CDRL_Table_of_Contents.doc

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Active Duty Dental Program (ADDP)
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HT9402-13-R-0002
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Exhibit B CDRL Table of Contents

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Text version

Exhibit B Contract Data Requirement List (CDRL)

CDRL Table of Contents The Contractor shall provide all reports and plans that are specified here. The Contractor is accountable for assuring that reports contain accurate and complete data. The Contractor shall prepare written procedures describing the source of information as well as the specific steps followed in the collection and preparation of data for each report. All reports must be supported with sufficient documentation and audit trails. The reports shall be titled as listed. The Contractor shall submit a negative report if there is no data to report. Required reports include:

Monthly Reports M010 Monthly Management Report

M020 Monthly Market Basket Comparison / CDT Summary Report M030 Monthly HIPAA/Privacy Complaint Report

M040 Monthly ADDP MDR Data Elements File M050 Monthly Provider Network Access Report Quarterly Reports Q010 Quarterly Report on Quality Management and Quality Improvement Program

Q020 Quarterly ADDP Fraud and Abuse Summary Report Semi-Annual Reports

S010 Semi-Annual Subcontracting Report for Individual Contracts and Summary Subcontract Report

Annual Reports AR010 Annual Market Basket Comparison / CDT Summary Report

AR020 Annual Letter of Assurance (PI) AR030 Annual Fraud Prevention Savings Report (PI) AR040 Annual Network Provider Listing AR050 Annual Contractor Manpower Reporting Annual Plans AP010 Annual ADDP Privacy Risk Assessment Results AP020 Annual Education Plan AP030 Annual Continuity of Operations Plan (COOP) AP040 Annual Checklist and Certification for Minimum Level of Enhanced Safeguarding for Unclassified DoD Information

Special Reports

SR010 Terrorist Threats (PI) SR020 Free Commerce Interference (PI) SR030 Recoupment (PI) SR040 Weekly Transition-In Status Reports

SR050 Weekly Phase-Out Status Reports

SR060 Initial Provider Network Access Report – Remote (Transition-In)

SR070 DSMO Trip Report

SR080 Ad Hoc Management Reports

SR090 Written Determination Report

SR110 Consolidated ADDP Utilization History Data Report SR120 Education Memorandum of Understanding (MOU)

Special Plans SP010 Fraud Detection and Prevention Strategy (PI) SP020 Initial ADDP Privacy Risk Assessment & Plan SP030 Transition-In Plan SP040 Phase-Out Plan

SP050 Revised Transition-In Plan SP060 Quality Management/Quality Improvement (QM/QI) Program Plan

SP070 Disaster Action Plan As Required Reports R010 Privacy Breach Incident Report

R020 Systems of Records Notices Report

HT9402-13-R-0002

J-2

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