Gap Split Network Standard Retail - number of days in 1 month supply

SAS Name
GAP_DAYS_INNPP_1M

This variable identifies the number of days in a one month supply of a drug on this tier, when using an in-network non-preferred pharmacy (INNPP; also known as a standard retail pharmacy within a split network) during the coverage gap phase of the Part D benefit.

Comments

This variable will only be populated if the plan has an enhanced benefit design with extra coverage in the gap. The coverage gap is technically referred to as the initial coverage limit (ICL) for the Part D benefit.

Starting in 2016, CMS changed how they describe pharmacy networks. The INNPP are currently referred to as standard retail pharmacies within split networks. There is no change in the meaning of the variable, and the data values are the same over time.

The CCW constructs the Plan Characteristics File from information submitted by plan sponsors to CMS’s Health Plan Management System (HPMS).

Employer and National Program of All-inclusive Care for the Elderly (PACE) plans are waived from reporting Plan Benefit Package information.

For those plans that did not report, the value of this variable will be blank.

Source: CMS (HPMS Files)