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Medicare Advantage/Part D Contract and Enrollment Data

Overview

The Medicare Advantage (MA) / Part D Contract and Enrollment Data section serves as a centralized repository for publicly available data on contracts and plans, enrollment numbers, service area data, and contact information for MA, Prescription Drug Plan (PDP), cost, PACE, and demonstration organizations.

The monthly updates to these contract and enrollment reports are scheduled to be published to the web site by the 15th of each month with the exception of the CAP Reports which are published to the web site on the 1st of each month.

An inventory of the currently available reports is provided below with a brief description of the content.

 

Monthly Contract and Enrollment Summary Report

Provides the number of contracts, MA only enrollment, Part D enrollment, and total enrollment by organization type. This report contains all organization types.

Monthly Enrollment by Contract

Provides monthly enrollment for each contract. This report contains all organization types.

Monthly MA Enrollment by State/County/Contract

Provides monthly enrollment at the state/county/contract level for all organization types except for PDP and employer-direct PDP.  

Note: An abridged version is also provided that excludes rows with 10 or less enrollees.

Monthly PDP Enrollment by State/County/Contract

Provides monthly enrollment at the state/county/contract level for PDP and employer-direct PDP organizations.

Note: An abridged version is also provided that excludes rows with 10 or less enrollees.

MA Contract Service Area by State/County

Provides contract service area by state and county for all organization types except for PDP and employer-direct PDP.

PDP Contract Service Area by State/County

Provides contract service area by state and county for PDP and employer-direct PDP organizations.

State Service Area

Provides the list of states covered in whole or in part by each contract. This file contains all organization types.

Enforcement ActionsProvides data on enforcement actions taken by CMS against MA and PDP organizations since January 2006.
Special Needs Plan (SNP) DataProvides monthly plan enrollment for each SNP and provides totals by SNP type.  
Enrollment by PlanProvides enrollment for each contract/plan benefit package. This annual report contains all organization types.  NOTE: The Contract Year 2007 annual report is now available (published July 2007).  
Corrective Action PlansProvides data on corrective action plans requested from MA and PDP organizations in response to audits and other ad-hoc compliance activities.

MA Claims Processing Contacts

Provides a claims processing contact for each MA, cost, PACE, and demo organization. Note: This directory is populated using the MA Claims Processing Contact field maintained by organizations in HPMS.

Plan Directory for MA, Cost, PACE, and Demo Organizations

Provides a plan contact for each MA, cost, PACE, and demo organization. Note: This directory is populated using the Plan Directory Contact for public web site field maintained by organizations in HPMS.

HEDIS Public Use Files
Provides annual Medicare Health Plan Employer Data and Information Set (HEDIS) performance measures.
PDP Plan DirectoryProvides a plan contact for each PDP organization. Note: This directory is populated using the Plan Directory Contact for public web site field maintained by organizations in HPMS.


Downloads

Medicare Advantage 2007 Overview [Zip, 7KB]
2006 Part D Payment Reconciliation  [PDF, 230 KB]
Revisions to the MA and Part D Prescription Drug Contract Determinations, Appeals, and Intermediate Sanctions Processes - CMS-4124-FC [PDF, 622 KB]
Related Links Inside CMS

Historical Health Plan Reports, Files, and Data
Medicare Advantage – Rates & Statistics
Prescription Drug Coverage – General Information
Health Plans – General Information

Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS.

 

Page Last Modified: 04/15/2008 3:18:17 PM
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