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2025 Medicare Part C & Part D Reporting Requirements & Data Validation

Data Validation Findings Submission Requirements

DVCs use an Excel version of the EES to record findings and then translate the findings into the PRDVM in a data file upload. CMS requires the DVC to record notes, data sources referenced, and findings for the different standards and criteria specified for a given reporting section. Also, CMS requires the DVC to enter comments that explain the reason for the finding’s determination and whether they report the findings on a binary scale or a Likert scale.

Following conclusion of the DV review and finalization of findings, the DVC should report the findings by uploading the EES (Appendix B) to CMS via the PRDVM in HPMS by June 15. The PRDVM Quick Reference Guide has instructions for using this module, which is available in the PRDVM. The EES includes review results and data sources that were reviewed for each standard or sub-standard, as well as the Yes, No, or Not Applicable finding, or a 1-5 Likert scale connected with each standard or sub-standard.

DVCs should also show which extraction method (full census or sample) was used for each standard. DVCs can enter and edit findings and notes periodically throughout the review process before submitting them to CMS.

The DVC shows the sample size used for any source data selected and includes the number and percentage of errors or variance. CMS defines an error as any discrepancy that either changes the number of events reported or has the potential to change the number of events reported in future reporting periods.

On or after June 15, the DVC can request an extension to submit DV findings. Requests cannot be submitted before June 15.