Updated research request forms and data security approval requirement effective 4/24/23
This variable is contained in the following files:
SAS Name
DED_COSTSHARE_TIERS
This variable identifies which formulary tiers require beneficiary cost sharing during the Part D deductible phase.
The value contains a string of binary digits; each digit of the value indicates which tiers are on the formulary.
Binary character string, where each digit is a 1 or 0, to accommodate each tier. Each
position of the character string represents a tier. For example if the value=011000 (1s in
the 2nd 3 digits), then cost-sharing applies to the 2nd and 3rd tiers of the formulary.
position of the character string represents a tier. For example if the value=011000 (1s in
the 2nd 3 digits), then cost-sharing applies to the 2nd and 3rd tiers of the formulary.
| Code | Code value |
|---|---|
| 1 in 1st digit | Tier 1 |
| 1 in 2nd digit | Tier 2 |
| 1 in 3rd digit | Tier 3 |
| 1 in 4th digit | Tier 4 |
| 1 in 5th digit | Tier 5 |
| 1 in 6th digit | Tier 6 |
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)