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

Translating Findings into Scores at the Standard/Sub-Standard & Reporting Section-Level

For each of the standards, sub-standards, and data elements assessed for compliance, the DVC assigns a "Yes/No" finding, or assigns a score using a 1-5 Likert scale to assess the degree of compliance. A "No" or 1, 2, or 3 finding will result in a score of zero percentage points. A 4 finding will result in 75% of the maximum possible percentage points for the standard, sub-standard, or data element. A 5 finding will result in 100% of the maximum possible percentage points for that standard, sub-standard, or data element.

The total percentage score calculation will be adjusted by the DVC in cases where a standard, sub-standard, or data element is "Not Applicable."

Table 24 illustrates an instance where the DVC has determined a "Yes" or 5 finding for every standard, sub-standard, and data element except Standard 5. Standard 5 received a "No" finding, and therefore, no percentage points are assigned to the actual score for this standard. In this example, there weren't any "Not Applicable" findings for this reporting section. The maximum possible score this reporting section is 100.0000%, and the actual score is 99.0000%. The percentage score is calculated by dividing the actual score by the maximum possible score (99.0000% ÷ 100.0000%).

Table 24: Reporting Section Scoring Without "Not Applicable" Finding
Standard
(1)		Reviewer's Finding
(2)		Maximum Possible Score
(3)		Actual Score
(4)
1All sub-standards received “Yes” findings or scores of 57.0%7.0%
2All sub-standards and data elements received “Yes” findings or scores of 510.0%10.0%
3All sub-standards and data elements received “Yes” findings80.0%80.0%
4Standard received “Yes” finding1.0%1.0%
5Standard received “No” finding1.0%0.0%
6Standard received “Yes” finding0.0%0.0%
7Standard received “Yes” finding1.0%1.0%
Totals100.0%99.0%
Percentage Score99.0% (99.0% ÷ 100.0%)

Percentages may not sum to totals due to rounding.

Table Description

This table illustrates the scoring for a reporting section where there were no "Not Applicable" findings. It shows the maximum possible score and the actual score for each standard based on the reviewer's findings.

  • Standard 1:
    • All sub-standards received “Yes” findings or scores of 5.
    • Maximum Possible Score: 7.0%
    • Actual Score: 7.0%
  • Standard 2:
    • All sub-standards and data elements received “Yes” findings or scores of 5.
    • Maximum Possible Score: 10.0%
    • Actual Score: 10.0%
  • Standard 3:
    • All sub-standards and data elements received “Yes” findings.
    • Maximum Possible Score: 80.0%
    • Actual Score: 80.0%
  • Standard 4:
    • Standard received “Yes” finding.
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
  • Standard 5:
    • Standard received “No” finding.
    • Maximum Possible Score: 1.0%
    • Actual Score: 0.0%
  • Standard 6:
    • Standard received “Yes” finding.
    • Maximum Possible Score: 0.0%
    • Actual Score: 0.0%
  • Standard 7:
    • Standard received “Yes” finding.
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
  • Totals:
    • Maximum Possible Score: 100.0%
    • Actual Score: 99.0%
    • Percentage Score: 99.0% (Calculated by dividing the actual score by the maximum possible score: 99.0% ÷ 100.0%)