Medicare Advantage and Prescription Drug Plan CAHPS® Survey

Business Requirements
     

Minimum Business Requirements

Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS® Survey
2021 Minimum Business Requirements

A survey vendor and/or subcontractor(s) must meet all of the Survey Vendor Minimum Business Requirements listed below in order to apply to administer the Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS® Survey[1]. Organizations that are approved to administer the MA & PDP CAHPS Survey must conduct all of their business operations within the United States so the MA & PDP CAHPS Survey Project Team can perform the required oversight activities.

Any organization that performs key survey administration functions on behalf of an MA & PDP CAHPS Survey vendor that requires receipt of an electronic file containing beneficiary-level personally identifiable information (PII) shall be referred to hereafter as a “subcontractor.”

 

1.      Relevant Survey Experience
Demonstrated recent experience in fielding Mixed Mode surveys.

 

Criteria

Survey Vendor

Survey Experience

·          Survey vendor and/or subcontractor(s) must have prior experience (minimum of 3 years) conducting surveys with the Medicare population

·          Survey vendor and/or subcontractor(s) must have prior experience (minimum of 3 years) administering CAHPS surveys within the most recent 5-year time period

·          Survey vendor and/or subcontractor(s) must have prior experience (minimum of 3 years) conducting large-scale Mixed Mode surveys (i.e., mail survey administration followed by survey administration via computer assisted telephone interview [CATI] follow-up of non-respondents) within the most recent 2-year time period

·          If applicable, poor past performance by survey vendor and/or subcontractor(s) on CMS beneficiary surveys will be considered as vendor failing to meet minimum business requirements. For example:

o    Not adhering to the timeline and/or procedures for survey administration

o    Not adhering to required oversight activities

o    Not adhering to Event Report procedures and corrective actions

Number of Years in Business

·            Survey vendor must have minimum of 4 years[2]

Experience with Multiple Survey Languages

·          Survey vendor and/or subcontractor(s) must have prior experience conducting surveys in both English and Spanish. A survey vendor will have the option of electing to conduct the MA & PDP CAHPS Survey in Chinese, Vietnamese, and Korean.

 

2.     Organizational Survey Capacity
Capability and capacity to handle required volume of mail questionnaires and conduct standardized telephone interviewing in a specified time frame.

 

Criteria

Survey Vendor

Personnel

·         Designated Personnel:

o      Project Manager with a minimum of 3 years relevant Mixed Mode (mail survey administration followed by CATI administration with non-respondents) survey experience

o      Mail Survey Supervisor with a minimum of 1 year previous experience in role

o      Telephone Survey Supervisor with a minimum of 1 year previous survey call center experience

o      Lead or Primary Programmer with a minimum of 1 year previous experience processing survey data and preparing data files for electronic submission

System Resources

·         System resources must meet CMS specifications in the QAP&TS and at a minimum include the following:

o      Physical facilities and electronic equipment and software for secure data collection processing and reporting

o      Production of computer files

o      Electronic survey management system to track fielded surveys through the entire protocol that protects the confidentiality of personally identifiable information and survey data received from beneficiaries (e.g., password protections, firewalls, data encryption software, personnel access limitation procedures, and virus and spyware protection)

o      A secure commercial work environment for receiving, processing, and storing hardcopy questionnaires and hardcopy sample files that protects the confidentiality of beneficiary response data and personally identifiable information

o      Anticipate and plan for site visits

Approved Use of Subcontractors

·         Subcontractors must meet the criteria outlined for the survey administration activities the subcontractors will be performing. Subcontractors will be assessed at the time of application and must be approved by CMS.

Mixed Mode Administration

·         Responsible for reproduction, printing, and mailing of survey materials in accordance with specifications provided

·         Capacity for conducting telephone interviews using a CATI system

·         Follow MA & PDP CAHPS Survey timeline

·         Use commercial software/resources to ensure that addresses and telephone numbers are accurate and correct for all sample members

·         If a survey vendor intends to administer the MA & PDP CAHPS Survey in Chinese, Vietnamese, and/or Korean, both the mail and telephone modes must be administered in these languages

·         Survey vendor must have the capacity to maintain an interviewer pool that meets the needs of beneficiaries in all languages in which the survey is administered

·         Survey vendor must have the capacity to conduct accurate monitoring of interviewers in all languages in which the survey is administered

·         Mail survey administration and telephone interviews are not to be conducted from a residence, nor from a virtual office

·         Survey vendors will be required to attest that procedures used to dial cell phones adhere to the vendor’s legal or compliance department requirements for adherence to the Telephone Consumer Protection Act of 1991, known as TCPA

Data Submission

·         Register for access to the MA & PDP CAHPS Data Warehouse and follow data specifications and procedures in order to submit and receive encrypted data via the Internet

·         Execute business associate agreement with health or drug plans and receive annual authorization from health or drug plans to collect data on their behalf and submit to CMS

Data Security and Confidentiality

·         Returned paper questionnaires must be stored in a secure and environmentally safe location

·         Firewalls and/or other mechanisms must be utilized to protect against unauthorized access to electronic files

·         Electronic security via implementation of access levels and passwords must be instituted

·         Daily data back-up procedures that adequately safeguard system data must be implemented

·         Develop a disaster recovery plan to support continued business operations or recovery in the event of a natural or human-related disaster

·         Required encryption protocols must be utilized for transmitting data files. CMS-defined personally identifiable information (PII) must be transmitted securely (e.g., encrypted file via email, data portal, or SFTP).

·         Develop procedures for identifying and handling breaches of confidential data

·         Ensure Data Use Agreement (DUA) with CMS is kept up to date and that all DUA requirements are followed, including cell size suppression rules

·         Develop and execute confidentiality agreements which include language related to HIPAA regulations and the protection of patient information, and obtain signatures from all personnel with access to survey information, including staff and all subcontractors involved in survey administration and data collection

o    Confidentiality agreements must be reviewed and re-signed periodically, at the discretion of the survey vendor, but not to exceed a three-year period

·         Vendors and subcontractors (if applicable) must document compliance with HIPAA regulations with regard to beneficiary protected health information (PHI)

o    Vendors must not share identifying information about beneficiaries in the survey sample with health or drug plans

·           Vendors must receive approval from CMS to append any additional data to the sample file

Data Retention

·         Retain all data files, audio recordings, and paper copies or scanned images of surveys for a minimum of 3 years. The retention requirement also applies to sample information. Retention of data will require extension of the CMS Data Use Agreement (DUA).

o    Archived electronic data files, audio recordings, and paper copies or scanned images of surveys must be easily retrievable

Technical Assistance/Customer
Support

·         Establish toll-free customer support telephone lines with live operator during regular business hours (to be established from the time of the pre-notification letter through the end of data collection)

·         Accommodate both Spanish and English inquiries

·         Accommodate Chinese, Vietnamese, and/or Korean inquiries if administering the MA & PDP CAHPS Survey in these optional languages



3.     Quality Control Procedures
Personnel training and quality control mechanisms employed to collect valid, reliable survey data.

 

Criteria

Survey Vendor

Demonstrated Quality Control Procedures

·       Set-up, conduct, and document quality control procedures for all phases of survey implementation, including:

o      Monitoring of subcontractor(s) if applicable

o      Training

o      Printing, mailing, and recording receipt of surveys

o      Telephone administration and monitoring of survey (electronic telephone interviewing system) in all languages in which the survey is administered

o      Coding, editing, or keying in survey data

o      Preparing final person-level data files for submission

o      All other functions and processes that affect the administration of the MA & PDP CAHPS Survey

·       Develop and submit annual Quality Assurance Plan by specified due date

·       Submit an Event Report to CMS within one business day of becoming aware of an event in survey administration

Training Requirements

·       Participate in and successfully complete MA & PDP CAHPS training webinar(s) for vendors

·       Complete a training evaluation to assess comprehension of MA & PDP CAHPS Survey protocols

·       Participate in any refresher training sessions or webinars

Training Participants

·       Project Manager, Mail Survey Supervisor, and Telephone Survey Supervisor at a minimum

·       Project staff member(s) are also recommended to attend training if they are responsible for the following functions:

o    Decrypting the sample file and performing sample file quality checks

o    Programming the CATI script

o    Preparing and submitting the survey data file

·       At least one representative from a subcontractor organization must attend training if that subcontractor will be conducting any of the functions below:

o    Inserting or survey packet preparation

o    Processing of returned mail surveys

o    Conducting telephone interviews (CATI administration)

Oversight

·       Vendors and their subcontractors are subject to oversight activities, including in-person visits to business operation site(s) to observe MA & PDP CAHPS mail production, CATI survey administration, and/or data preparation and submission

·       Survey vendor must be prepared to provide access to all aspects of MA & PDP CAHPS survey administration for the site visit  team

·       Submit survey mail materials and CATI screenshots to the project team for review by specified due date

·       Organization must be prepared to submit reports as requested by the project team, such as reports of outbound CATI  progress

 

 

 4.     Approval Term
         An approved survey vendor may administer the MA & PDP CAHPS Survey for the specified amount of time.

Criteria

Survey Vendor

Approval Term

·       Approval is for a fixed 1 year term

·       In determining vendor approval, CMS will consider past performance, as a survey vendor or subcontractor, in support of CMS activity. Performance criteria include, but are not limited to:

o      Occurrence of similar substantive errors within or across projects

o      Significant non-compliant items identified during site visits or monitoring

o      Receipt of a corrective action memo from CMS

o      CMS requests for quality improvement plans

o      Refusal to allow site visit team to observe MA & PDP CAHPS production activities

·       Approval as a survey vendor in prior years does not guarantee future approval

 



[1] CMS may grant survey vendors exceptions on a case-by-case basis to MA & PDP CAHPS Survey on-site operating requirements in the event of a public health emergency during administration of 2021 MA & PDP CAHPS.

[2] Subcontractor experience cannot be used to fulfill the number of years in business requirement.

 

This page was last modified on 6/9/2020