A survey vendor must meet all of the Minimum Business Requirements in order to apply to administer the Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS® Survey.
This participation form is to be completed by organizations requesting approval to administer the 2020 Medicare Advantage and Prescription Drug Plan CAHPS® Survey (MA & PDP CAHPS). 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. This requirement also applies to all staff and subcontractors.
ALL VENDOR APPLICATIONS AND MATERIALS ARE DUE BY 7/12/2019 AT 5:00 PM (EDT)
This section is to be completed with general information for participation in MA & PDP CAHPS Survey Data Collection.
1. Applicant Organization
2. Applicant Contact Person
3. LIST OF PHYSICAL LOCATION(S) WHERE SURVEY VENDOR CONDUCTS SURVEY ADMINISTRATION ACTIVITIES
1. Have you been approved as a vendor to implement other CMS or CMS CAHPS surveys in the past five years?
If Yes, please provide the name of the survey(s) for which you have been approved as a vendor in the table below (Section II. 1. Relevant Survey Experience).
2. Have you been a subcontractor to an approved vendor for other CMS or CMS CAHPS surveys in the past five years?
If Yes, please provide the name of the survey vendor(s) and the survey(s) for which you have been a subcontractor.
3. If Yes to 1 or 2 above, have you had any past performance issues that resulted in corrective action memos, special CMS requests for quality improvement plans, submission of data that was withheld from public reporting, or withdrawal for approval? If Yes, please detail.
CMS will consider past performance, as either a survey vendor or subcontractor, on CMS or CMS CAHPS surveys when reviewing your organization’s MA & PDP CAHPS Survey Participation Form.
Survey vendors must meet the following Minimum Business Requirements. Please check Yes or No for each item below to indicate that the organization has read and meets the following Minimum Business Requirements.
1. Relevant Survey Experience Demonstrate recent experience in fielding surveys via Mixed Mode (mail survey administration followed by survey administration via computer assisted telephone interview [CATI] follow-up of non-respondents).
Survey experience: Organization has minimum of 3 years demonstrated prior experience conducting surveys with the Medicare population and administering CAHPS surveys. Organization has minimum of 3 years experience conducting large-scale Mixed Mode Survey (mail survey administration with CATI system telephone follow-up to non-respondents) within the most recent two year time period.
For Medicare population and CAHPS surveys list the five most recent survey projects in which your organization administered surveys:
Number of years in business: Survey vendor has been in business a minimum of four years.
Experience with Multiple Survey Languages: Survey vendor has prior experience in 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, Korean and Vietnamese.
2. Organizational Survey Capacity Capability and capacity to handle a required volume of mail questionnaires and conduct standardized telephone interviewing in a specified time frame.
Personnel: Survey vendor has designated personnel, including: a Project Manager with minimum of 3 years relevant Mixed Mode survey administration experience; a Telephone Survey Supervisor with a minimum of 1 year prior call center experience; a Mail Survey Supervisor with a minimum of 1 year prior experience in role; and Lead or Primary Programmer with a minimum of 1 year prior experience in survey data processing and preparing data files for electronic submission.
System Resources: Survey vendor has physical plant resources available to handle the volume of surveys being administered, including: physical facilities, electronic equipment and software for secure data collection processing and reporting and an 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). Survey vendor has a disaster recovery plan in place for continued business operations in the event of a natural or human-related disaster. Survey vendor business operations are conducted in a secure commercial work environment.
Mixed-Mode of Survey Administration: Survey vendor is capable of reproducing, printing and mailing survey materials in accordance with specifications and timeline provided and uses commercial software/resources to ensure that addresses and telephone numbers are accurate and correct for all the sample members. Survey vendor has capacity for conducting telephone interviews using CATI system. Note: If a survey vendor intends to administer the MA & PDP CAHPS Survey in Chinese, Korean and/or Vietnamese, both 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, and conduct accurate monitoring of interviewers in these languages. Mail survey administration and telephone interviews shall not be conducted from a residence or from a virtual office.
Data submission: Survey vendor has the capacity to register with the RAND Corporation 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. Authorizations and business associate agreements will be established between survey vendor and health or drug plan.
Data Security: Survey vendor will ensure Data Use Agreement (DUA) with CMS is kept up to date and that all DUA requirements are followed, including cell size suppression rules. Vendors must receive approval from CMS to append any additional data to the sample file.
Data Retention: Survey vendor has the capacity to retain all data files for a minimum of 3 years, including sample information. Archived electronic data files, paper copies and/or scanned images will be easily retrievable.
Confidentiality: Survey vendor has the capacity to comply with all HIPAA rules and regulations and store MA & PDP CAHPS data files, including sample information, securely and confidentially. Survey vendor will execute confidentiality agreements with staff and subcontractors (if applicable). Vendors must not share identifying information about beneficiaries in the survey sample with health or drug plans.
Technical Assistance/Customer Support: Survey vendor has the capability and capacity to provide toll-free customer support telephone lines with the ability to respond to both Spanish and English inquiries. Note: If a survey vendor intends to administer the MA & PDP CAHPS Survey in Chinese, Korean and/or Vietnamese, the survey vendor must have the capability and capacity to respond to inquiries received in these optional languages.
3. Quality Control Procedures Personnel training and quality control mechanisms employed to collect valid, reliable survey data.
Demonstrated Quality Control Procedures: Survey vendor has the capacity to set-up, conduct and document quality control procedures for all phases of survey implementation including: monitoring of subcontractors, if applicable; training; printing, mailing, and recording receipt of surveys; telephone administration and monitoring of survey (electronic telephone interviewing system) in all languages in which the survey is administered; coding, editing, or keying in survey data; preparing final person-level data files for submission; and all other functions and processes that affect the administration of the MA & PDP CAHPS Survey. Survey vendors must develop and submit Quality Assurance Plan by specified due date. Survey vendor must submit an Event Report to CMS within one business day of becoming aware of an event in survey administration.
4. Explanation Please explain any “NO” responses above.
List of key project staff
A subcontractor is 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).
LIST OF SUBCONTRACTORS (add more lines if necessary or include as a separate attachment). Note: Survey vendors must submit any changes in subcontractors to CMS for approval. CMS will review all subcontractors prior to authorization.
Please submit a CV for all identified key project staff for both survey vendor and subcontractor(s) via the MA & PDP CAHPS Technical Assistance email at MA-PDPCAHPS@HCQIS.org.
Any organization participating in the Medicare Advantage and Prescription Drug Plan (MA & PDP) CAHPS Survey must adhere to the following Rules of Participation. To be eligible, the organization must:
I certify that:
Submit this form online at www.ma-pdpcahps.org.
For assistance, please contact the MA & PDP CAHPS Survey Project Team by telephone at 1-877-735-8882 or email at email@example.com.
You will receive notification once the form has been successfully submitted.