Information to Review Data Used for Medicare Part C and D Star Ratings and Display Measures

Relevant to: All Medicare Advantage Organizations, Prescription Drug Plans, and Section 1876 Cost Plans

As discussed in the December 22, 2023, Heath Plan Management System (HPMS) memorandum titled “ACTION: Open-ended Low Income Subsidy (LIS) periods correction,” on November 8, 2023 a data cleanup was conducted to correct open-ended LIS periods that were out of sync with Social Security Administration (SSA) records. New end dates to LIS periods were retroactively populated, which caused unanticipated beneficiary impact, resulting in some beneficiaries being notified of retroactive premium and/or cost-sharing amounts due. CMS requested that Medicare Advantage (MA) organizations and Medicare Part D plan sponsors pause any collection efforts for Part D premiums or cost-sharing for the beneficiaries impacted by the cleanup and continue to administer the Part D benefit with LIS-level premiums and cost-sharing by disregarding the updates to the beneficiaries’ retroactive LIS end dates received on the November 10, 2023 Daily Transaction Reply Report (DTRR) file with 223 (Low Income Period Removed from Enrollment
Period) or taking other, similar action.

See the full guidance for more information.