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Step | Responsible Party | DV Activities | Timeline |
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1 | SO | Select appropriate DVC based on “Standards for Selecting a Data Validation Contractor” | December - March |
2 | DVC, SO | Notify CMS of DVC selection / Request access to Health Plan Management System (HPMS) Plan Reporting Data Validation Module (PRDVM) | January - April |
3 | DVC, SO | Complete the web-based DV Training | February - March |
4 | DVC, SO | Review all DV documents | January - March |
Note: References to December refer to the calendar year before the DV review; all other references to months refer to the same calendar year as the DV review.
Step | Responsible Party | DV Activities | Timeline |
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5 | SO | Complete Organizational Assessment Instrument (OAI) and provide appropriate documentation to selected reviewer per the OAI's documentation request | March 1 - April 1 |
6 | DVC, SO | Analyze OAI Responses | March 1 or later |
7 | DVC, SO | Prepare for physical or virtual site visit (site visit agenda, resource needs, and logistics) | Early April |
8 | DVC, SO | Conduct on-site review (convene entrance conference, conduct interviews with SO staff, observe SO's reporting processes, and obtain census and/or sample files) | Early April (allow for up to 1 week) |
9 | DVC | Request additional documents following site visit (if applicable) | Mid/late April |
Step | Responsible Party | DV Activities | Timeline |
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10 | DVC | Determine compliance with “Data Validation Standards” and record findings in Excel-version of the Findings Data Collection Form (FDCF) | June |
11 | DVC | Provide draft findings to SO | June |
12 | DVC, SO | Review draft findings and obtain additional documentation necessary to resolve issues | June |
13 | DVC | Submit DV review findings to CMS via HPMS PRDVM and receive DV scores | No later than June 30 |
Step | Responsible Party | DV Activities | Timeline |
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14 | DVC, SO | Compile archive of DV work papers | July 31 |
15 | SO | Receive Pass or Not Pass threshold level and assess Pass or Not Pass determination based on final DV scores | Summer/Fall |
16 | SO | Appeal DV determination(s) (if applicable) | Within 5 days of receiving threshold level from CMS |
Select the Job Aid button to view the 2018 Data Validation (DV) Activities job aid featuring the DV program activity steps. You are encouraged to print this job aid for reference throughout DV process. It may also be accessed by selecting the Reference button at the top of each page.
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