Pre-ICL Copay Split Network Standard Mail Order - 1 day supply

SAS Name
PRE_ICL_MONPP_COPAY_DAILY

This variable identifies the beneficiary copay amount for a one day supply of the drugs on this tier, using mail order non-preferred pharmacy (MONPP; also known as a standard mail order pharmacy within a split network) during the pre-initial coverage limit (ICL) phase of the Part D benefit.

Comments

Starting in 2016, CMS changed how they describe pharmacy networks. The MOPP are currently referred to as standard mail order 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)