Reporting Requirements (RR) data are submitted to CMS by Part C and Part D sponsors on an annual basis as a condition of their participation in the Medicare Advantage and Part D Prescription Drug Benefit Program.
The RR Limited Data Set (LDS) file contains individual datasets for each Part C and Part D reporting section, listing the raw data as reported by contracts, and if applicable, validated by independent contractors. With a few exceptions, CMS will release all data elements collected within a reporting section in the LDS. Beneficiary information, proprietary, confidential, or otherwise sensitive data are not included.
For reporting sections that undergo data validation (DV), CMS only releases data in the LDS for contracts receiving at least the minimal DV score to pass. Contracts which did not pass DV are listed to indicate that CMS identified issues with plan’s data. Also, contracts that passed DV but were later found to have significant data issues may be excluded. More information about the DV standards can be found at https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/part-c-and-part-d-data-validation.
Data elements are listed as they appear in the Part C and Part D RR documents. Users should carefully review the applicable RR and Technical Specifications documents for each Contract Year as they may change from year to year.
The RR documents can be found at the following locations:
- Part C reporting sections - https://www.cms.gov/medicare/enrollment-renewal/health-plans/part-c
- Part D reporting sections - https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/part-d-reporting-requirements
Data availability: The RR LDS file is released on an annual basis following the DV process and other CMS reviews, typically by 4th quarter of the following year. CMS cannot guarantee the release of these data files to meet any timeframe.
Data format: Comma separated variable block with SAS® read-in program.
Cost: $2,000
Approximate size: Less than 1 MB per file
See downloads section for technical specifications including file layout.