Gap Standard Mail Order - number of days in 3 month supply
SAS Name
GAP_DAYS_MO_3M
This variable identifies the number of days in a 3 month supply of a drug on this tier, when using a standard mail order pharmacy 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 mail order pharmacies are currently referred to as standard mail order pharmacies. 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.
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 mail order pharmacies are currently referred to as standard mail order pharmacies. 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)