Back to top
This variable is contained in the following files: Plan Characteristics File
SAS Name
OOPT_AMT

This variable is the dollar amount of the Medicare-defined Part D annual Out-of-Pocket (OOP) Cost Threshold.

This field is blank for Fixed Capitated Reinsurance Demonstration Projects

Comments

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)