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Title
Notice of Intent to Change an Existing Contract Attribute for Existing Contractors
Date
11/13/2006

To ensure clear and timely communications with CMS, all existing contractors seeking to change a contract attribute to a Part C, Part D or Employer Group Waiver Plan (EGWP or "800 Series") products should notify CMS of their intent by completing the attached form and submitting it to CMS by 5:00 p.m. EST on December 1, 2006. Organizations that submit notices of intent to change a contract attribute are not obligated to submit an application to CMS.

Note: This Notice of Intent to Change an Existing Contract Attribute is for existing contractors seeking to change a Part C, Part D or EGWP contract attribute.

Example 1: If you are a current MA contractor offering a MA-Only PFFS in CY 2007, and would like to offer an MA-PD PFFS under that contract in CY 2008, then you should submit this form.

Example 2: If you are a current contractor seeking to expand the service area under your existing contract, then you should submit this form.

Example 3: If you are a current PDP or MA contractor offering plans to individual beneficiaries in CY 2007, and would like to offer "800 Series" EGWPs under that contract in CY 2008, then you should submit this form.

Submit the completed form by email to: drugbenefitimpl@cms.hhs.gov by December 1, 2006 by 5:00 p.m. EST. Be sure to indicate "Notice of Intent to Change" in the subject line.