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

Lesson 3 Summary

  • SOs and DVCs can submit DV questions year-round to [email protected]
  • SOs can appeal findings within 5 business days post-June 15 deadline by emailing CMS with the subject: “Data Validation: Appeal”
  • Include SO name, CMS contract numbers, contact info, and DVC organization in submissions
  • For appeals, provide reporting section name, standard/sub-standard ID, finding description, disagreement reason, resolution steps, and outcomes
  • DVCs must share draft findings with SOs and resolve issues before the June 15 final submission
  • DVCs use an Excel version of the EES to document findings and upload them to the PRDVM by June 15
  • Record notes, data sources, and findings for standards, indicating compliance on a binary or Likert scale
  • An error is any discrepancy that may affect future reported events
  • DVCs can request extensions for findings starting on or after June 15
  • The EES has specific columns for review results and findings, with guidance for compliance and error ratings

  • DV reviewers should enter notes and findings into the EES.
  • SOs shouldn’t hesitate to submit questions directly to CMS; while asking the DVC to submit on their behalf is acceptable, corresponding directly helps to make sure that the person asking the question gets a response that resolves their query.
  • Submit questions to CMS before the review cycle, when possible. This allows CMS time to prepare a response.
  • Include examples, where possible, in questions to CMS, especially if there’s a conflict in the interpretation of CMS’s guidance.
  • Identify an internal benchmark for what constitutes meeting a standard and what doesn’t, so there’s consistency among the DVC staff performing the review.