(General Information, Eligibility, and Entitlement Manual)

The TCR shall contain all TDLs issued that fiscal quarter, with the exception of contractor -specific TDLs. TDLs issued to specific contractor(s) shall be added by that contractor at the bottom of the report in red font.  If CMS omitted a TDL that should have been included in the report, the contractor shall add the TDL to the bottom of the report in red f ont.   A CMS Central Office (CO) representative will notify the MACs via a TDL (within two weeks of the end of each fiscal quarter) that the CRIR and TCR reports are available to download on Electronic Change Information Management Portal (ECHIMP).  MACs s hall enter all applicable information into the reports. MACs shall upload the completed reports into the CMS ART system. MACs shall also then send the completed reports to the CMS CO mailbox at CR_IMPL_REP ORTS@cms.hhs.gov .  NOTE:  There are no spaces in this email address. Underscore _ separates the words CR_IMPL_REPORTS.   The CRIR and TCR reports are due no later than the 28th of the month in which the reports are due, as indicated below.  If the report d ue date of the 28th falls on a weekend or a holiday; each MAC shall submit the report on the next business day following the due date.   Quarter 1 includes October, November, and December. The report for Quarter 1 is due no later than February 28th.    Quarter 2 includes January, February, and March. The report for Quarter 2 is due no later than May 28th.    Quarter 3 includes April, May, and June. The report for Quarter 3 is due no later than August 28th.    Quarter 4 includes July, August, and September. The report for Quarter 4 is due no later than November 28th.  Each MAC shall complete and submit one CRIR by jurisdiction, one TCR by jurisdiction, cover Letter/Attestation Statements, and if necessary, a separate explanation document.  MACs with multiple jurisdictions may complete a separate sheet within a single Excel workbook for each jurisdiction.   In addition, each contractor shall write and maintain written procedures on its change management process (i.e., Standard Operating Procedures  SOP).  Elements sho uld include, but are not limited to, written procedures for the timely processing of CMS instructions (issued CRs and TDLs) from the CMS DRI MAILBOX and CMS TDL MAILBOX, written procedures of the contractors CR and TDL distribution process (including, but  not limited to, the dissemination of provider education information), written procedures for CR implementation and TDL compliance (including written documentation to verify implementation/compliance).   Contractors shall retain the written documentation to  verify CR and TDL implementation/compliance using CMSs records retention guidelines.   Upon request from CMS, contractors shall supply the written procedures of their change management process, as well as written documentation to verify CR and TDL impleme ntation/compliance to CMS.   Implementation Date   I. Definition   Refer to section 50.4.2 of this chapter for the definition of the implementation date.   II. Supporting Information  For any instruction affecting providers, regardless if there are Systems or Non- systems changes, CMS gives at least 90 days advance notice to the providers.  That is, CMS must issue the instruction at least 90 days prior to the implementation date to give  providers enough time to implement the instruction.  The vehicle used to alert providers 90 days prior to an instructions implementation date is the CMS Quarterly Provider Update, which can be accessed at: http://www.cms.hhs.gov/QuarterlyProviderUpdates/01_Overview.asp   There are four exceptions to the 90 days advance notice policy: (1) the instruction is contractor specific and therefore does not affect providers; (2) the instruction is a correction/clarification where the previously issued instruction contained typos or errors of fact or omissions; (3) the instruction is a routine or recurring item (which qualifies it to be included on the Mid- Quarter List in the Provider Update); and (4) the instruction is approved by the CMS Administrator to be published immediately or by a certain date.   If a previously issued instruction is re -issued with revised MAC requirements and a revised implementation date is not specified, MACs sh all comply with the revised instruction as soon as possible but no later than 10 business days from the CRs date of issuance.   For a system change, the Initiator of the CR will specify an implementation date that corresponds to one of the quarterly releas e dates. Usually, the quarterly release date will be the first Monday of the quarter.  Non- recurring system changes are usually issued five months in advance of the implementation date.  On occasion, an off -cycle release date can be approved by OSORA and/o r the Administrator.  This exception tends to occur most frequently with the implementation of National Coverage Determinations (NCDs) and corrections to finals.   For a Non- system change that has no impact on providers, the Initiator of the CR may specify the implementation date as 30 days from issuance.  For a Non- system change that has provider impact, the Initiator of the CR may specify the implementation date as 90 days from issuance.   After the comment period ends and the Initiator of the CR has addres sed all comments, he/she prepares a final CR package for CMS clearance.  The last part of the CMS clearance process involves obtaining approval from the Medicare Change Control Board (MCCB).  The MCCB, in consultation with the Initiator of the CR, will determine the time period needed for implementing each change request.  After the clearance process is completed, the Office of Strategic Operations and Regulatory Affairs/Issuances & Records Management Group (OSORA/IRMG) will insert the actual implementation  date before issuing the CR as a final instruction.  COMPLETING AND SUBMITTING THE QUARTERLY CR IMPLEMENTATION REPORT (CRIR)   Medicare Administrative Contractors (MACs) shall complete the CR Implementation Report, as follows, for each jurisdiction. MACs wi th multiple jurisdictions may complete a separate sheet within a single Excel workbook for each jurisdiction.  If CMS omitted a CR that should have been included in the report, the contractor shall add the CR to the bottom of the report in red font.  MACs shall update the report in the same manner as a CMS CO entered CR, unless specifically instructed below to exclude specific items.   Header Rows   The report contains three header rows.   1. Header Row 1, Contains the title, CR Implementation Report (CRIR)  Quarter X (MMM- MMM) YYYY, where X is the number of the quarter, MMM -MMM are the months included in that quarter, and YYYY is the Calendar Year.  This data will be completed by CMS CO.   2. Item 1: Header Row 2, MACs shall enter their Contractor Name and Juris diction identifier in Item 1 of the report.   3. Item 2: Header Row 2, MACs shall enter the Date Report Submitted to CMS in Item 2 of the report in MM/DD/YYYY.  [This is the date the report is e -mailed to CMS CO.]   4. Item 3: Header Row 2, Report Due.  This is the date the report is due to CMS CO.  This date will be completed by CMS CO.   5. Item 4: Header Row 3, CRIR Contractor Contact (First Name, Last Name, Phone).  MACs shall enter the first name, last name, and phone number of the individual CMS CO should conta ct to ask questions regarding information in this report.  Contact must be knowledgeable on the contents of the report.   Details Rows   Below the header Rows, Detail Rows shall be completed as follows:   1. Item 5 (No.) -  This field contains a consecutive number to track the number of CRs on the report.  CMS CO will complete this field for all CRs included on the report.  If the contractor adds additional CRs, they should continue numbering from the previous CMS entered row in red font.  For example, if CMS inc luded 15 CRs on the report, the contractor shall begin numbering in this field with 16 in red font.  2. Item 6 (CMS CR #) -  CMS CO will complete this field with the CMS CR numbers implemented during the quarter.   3. Item 7 (CMS Transmittal #) -  CMS CO will complete this field with the CMS CR transmittal numbers implemented during the quarter.  If a CR was issued with multiple transmittals, the word multiple will be entered in this field.   4. Item 8 (Subject) -  CMS CO will complete this field with the subject for all CMS CRs implemented during the quarter.   5. Item 9 (CMS Published Implementation Date MM/DD/YYYY) - CMS CO will complete this field with the CMS Published Implementation date in MM/DD/YYYY format for all CRs implemented during the quarter.   6. Item 10 (A pplicable Workload? (X or blank)) -  MACs shall complete this field with an X for all CRs applicable to their workload or leave the field blank if the CR is not applicable to their workload.  The CR is considered applicable to the contractor if any of the business requirements in the CR were required to be implemented by the contractor in the reporting period.  Note: Shared System Only CRs (with no MAC responsibility checked) are considered not applicable.   7. Item 11 (Completed by Implementation Date? (Y , N, or blank)) -  MACs shall complete this field with a Y for all CRs implemented on or before the CMS Published Implementation Date indicated in Item 9.  MACs shall complete this field with an N for all CRs that have not been implemented by the impl ementation date and MACs must select a Reason for Delay from Item 12.  This field shall remain blank if the CR is not applicable to the contractor (i.e. Item 10 is blank).  8. Item 12 (Reasons for Delay (leave blank if implemented by due date)) -  This field s hall remain blank if the CR has been implemented on or before the CMS Published Implementation date (Item 11 is Y) or is not applicable to the contractor workload (i.e. Item 10 is blank).  MACs shall select one of the following Reasons for Delay from the  drop down list for all applicable CRs not completed by the CMS Published Implementation date indicated in Item 9 (i.e. Item 10 has an x and Item 11 has a N):   01. Due date changed due to TDL  02. Due date changed due to CR  03. MLN delay  04. CMS delay of file transmiss ion 05. System related delay  06. CR extension approved or pending  07. Deadline past quarter end date  08. Other   Reason 01 (Due date changed due to TDL)  - Applies only in situations where CMS has issued a TDL which directs contractors to hold claims and/or otherwise delay  the work related to that specific CR.   Reason 02 (Due date changed due to CR)   Applies only in the following situations:   a. Correction final changed the CMS Published Implementation date to be different than the date indicated in Item 9;   b. CR was rescinded/replaced with a different CR number that changed the CMS Published Implementation date to be different than the date indicated in Item 9;   c. Correction or Rescinded/Replaced CR changed the due date of specific Business Requirements.   Reason 03 ( CM S MLN Matters  Article Delay) -  Applies only in situations where CMS issued the MLN Matters Article more than three days after the CR was posted on the CMS website. The contractor should include a comment in Item 13 that explains the activity that was not completed and the quarter in which the activity will be completed.  If a contractors quarterly bulletin is due to go out in another quarter, the CR should be added as an add- on in the quarter in which the activity occurred, including a comment that all activity for that CR has been completed.   Reason 04 (CMS delay of file transmission)  - Applies only in situations when the file needed to complete work indicated in the CR was not available timely (i.e., payment files related to annual recurring CRs such a s the HCPCS, Pricer, and OPPS).   Reason 05 (System related delay)   Applies only in the following situations:   a. Shared System Maintainer (SSM) production problem prevents a MAC from completing a specific task in the CR;   b. Non-MAC maintained system (e.g., PECOS, HIGLAS, CWF, etc.) production problem prevents a MAC from completing a specific task in the CR.    Reason 06 (CR extension approved or pending)  - Applies only in situations where CMS Contracting Officer Representativ e (COR) has approved an extension of the implementation date specifically referencing this CR.   Reason 07 (Deadline past quarter end date)  - Applies only in the following situations:   a. CRs with multiple implementation dates;