№ lp_2_3_25771
File format: docx
Character count: 4177
File size: 15 KB
Federal administrative reporting template and compliance instructions governing annual submission of prescription drug benefit data and rebate information by QHP issuers and PBMs to CMS under specified federal regulations.
OMB Control Number:
0938-1394
Expiration Date:
XX/XX/20XX
Issuing Agency:
Centers for Medicare & Medicaid Services (CMS)
Department:
U.S. Department of Health and Human Services (HHS)
Related System:
Health Insurance Oversight System (HIOS)
Legal Basis:
45 CFR 156.295(a); 45 CFR 184.50(a); 45 C.F.R. 155.260
Frequency of Reporting:
Annual
Estimated Time per Response:
122 hours
Applicability:
QHP issuers and Pharmacy Benefit Managers (PBMs)
Subject:
Prescription drug data, pricing, and rebate reporting
Data Elements:
Issuer_HIOS_Plan_ID; NDC; Total_Prescriptions_Dispensed_All; Total_Prescriptions_Dispensed_Retail_Pharmacies; Total_Prescriptions_Dispensed_Mail_Order_Pharmacies; Total_Rebate_Dollars
Submission Format:
Pipe-delimited .csv file
Confidentiality:
Privacy and Security of Personally Identifiable Information under 45 C.F.R. 155.260
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2014
Region / City:
Hines, Illinois
Topic:
Pharmacy Benefits Management Software
Document Type:
User Manual
Organization:
Department of Veterans Affairs
Author:
Department of Veterans Affairs Office of Information and Technology (OI&T)
Target Audience:
Pharmacy Personnel at Veterans Affairs Medical Centers (VAMCs), VISNs, Research Community
Period of Validity:
From June 2005 onwards
Approval Date:
June 2005
Date of Changes:
July 2014
Note:
Description
Year:
2025
Region / City:
Not specified
Subject:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Health plan enrollees
Period of validity:
July – December 2024
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Not specified
Theme:
Healthcare, Health Plans
Document Type:
Survey Script
Issuing Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees in Qualified Health Plans
Period of Validity:
2023
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2021
Region / City:
United States
Theme:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
QHP Issuer
Author:
Not specified
Target Audience:
QHP enrollees
Period of Action:
July through December 2020
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2026
Region / City:
Not specified
Subject:
Exception requests for variations from QHP Enrollee Survey requirements
Document Type:
Instructional Form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Vendors conducting the QHP Enrollee Survey
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Document type:
Internet survey script
Survey name:
Qualified Health Plan (QHP) Enrollee Experience Survey
Language:
English
Data collection mode:
Internet survey
Reference period:
July–December 2025
Reference period length:
6 months
Target population:
Qualified Health Plan enrollees
Subject area:
Health insurance enrollee experience
Regulatory authority:
Centers for Medicare & Medicaid Services
OMB control number:
0938-1221
OMB approval expiration:
September 30, 2026
Estimated completion time:
10 minutes
Survey sponsor:
Health plan issuers under QHP program
Data use purpose:
Enrollee experience measurement
Geographic scope:
United States
Document section:
Programming specifications and survey instructions
Source type:
Federal survey instrument documentation
Year:
2025
Region / City:
N/A
Theme:
Healthcare, Health Plans
Document Type:
Survey
Agency / Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
N/A
Target Audience:
Enrollees of Qualified Health Plans
Period of Validity:
From July to December 2024
Approval Date:
N/A
Date of Changes:
N/A
Year:
2024
Region / City:
Not specified
Topic:
Health care survey
Document Type:
Survey invitation
Organization / Institution:
Department of Health and Human Services
Author:
Not specified
Target Audience:
Enrollees of [QHP ISSUER NAME]
Period of Validity:
July - December 2024
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Contextual Description
Year:
2022
Region / City:
Not specified
Theme:
Healthcare, Health Insurance Surveys
Document Type:
Telephone Interview Script
Organization:
Not specified
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans
Period of validity:
From July to December 2021
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2022
Region / City:
United States
Theme:
Health care survey
Document Type:
Survey script
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans (QHP)
Effective Period:
2021-2022
Approval Date:
11/30/2023
Revision Date:
Not specified
Survey Format:
Online
Data Collection Method:
Internet survey
OMB Approval Number:
0938-1221
Year:
2022
Region / City:
United States
Topic:
Qualified Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Notice
Organization / Institution:
CMS (Centers for Medicare & Medicaid Services)
Author:
CMS
Target Audience:
Prospective vendors for the 2022 QHP Enrollee Survey
Effective Period:
July 15, 2021 - July 30, 2021
Approval Date:
July 30, 2021
Date of Changes:
None
Year:
2021
Region / City:
Not specified
Theme:
Quality Healthcare Programs, Enrollee Surveys
Document Type:
Instruction and Form
Organ / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Vendors involved in QHP Enrollee Survey
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2020
Region / city:
Not specified
Topic:
Health plan enrollee experience
Document type:
Survey
Organization / institution:
Not specified
Author:
Not specified
Target audience:
Health plan enrollees
Period of validity:
July – December 2019
Approval date:
Not specified
Date of changes:
Not specified
Year(s):
2022–2024
Country:
United States
Subject:
Essential Community Providers (ECP) requirements for Qualified Health Plan (QHP) certification
Document Type:
Supporting Statement / Administrative Justification
Issuing Authority:
Department of Health and Human Services (HHS)
Administering Agency:
Centers for Medicare & Medicaid Services (CMS)
Legal Basis:
Section 1311(c)(1)(C) of the Affordable Care Act; 45 CFR 156.235; Section 340B(a)(4) of the Public Health Service Act; Section 1927(c)(1)(D)(i)(IV) of the Social Security Act
OMB Control Number:
0938-1295
CMS Identifier:
CMS-10561
Applicable Programs:
Qualified Health Plans (QHPs); Stand-alone Dental Plans (SADPs)
Regulatory Focus:
Inclusion standards and data collection for Essential Community Providers
Geographic Scope:
Nationwide
Data Collection Method:
Online ECP Provider Petition
Target Entities:
Health care providers serving predominantly low-income, medically underserved individuals; QHP and SADP issuers
Related Benefit Year:
2022 benefit year