MAPD Help Desk

Email address:             MAPDHelp@cms.hhs.gov
Help Desk Phone:       1-800-927-8069

Medicare Advantage Prescription Drug (MAPD) Help Desk offers technical and functional support for the Medicare Advantage Health and Prescription Drug Coverage (Parts C and D) Programs.  This insurance coverage is provided by:

  • Medicare Advantage (MA) Plans.
  • Medicare Advantage Prescription Drug (MAPD) Plans.
  • Medicare Prescription Drug Plans (PDPs)
  • Third parties conducting data exchanges with CMS on behalf of MA/MAPD/PDPs.

Technical Support for Plan Connectivity and Access:

  • Startup, testing and implementation for connectivity to CMS systems.
  • Ongoing operational support for data exchanges and system problems.
  • IDM - Identity Management for CMS system access and password reset inquires and issues.

MAPD Functional Support for Inquires and Issues:

  • Coordination with CMS for beneficiary enrollment, disenrollment, payment and premium topics.
  • MARx UI - Medicare Advantage Prescription Drug User Interface.
  • eRPT - Electronic Retroactive Processing transmission.
  • ELMO - Eligibility Enrollment Medicare Online.
  • COB - Coordination of Benefits files.
  • MDR - Medicaid Drug Rebate State Exchange.

For helpful information about the following topics, please click the link:

Bulletin Board of Current Plan Communications

  • November 18, 2021 - MAPD Help Desk Closed on Thanksgiving Day, Thursday, November 25, 2021

Please be advised that the MAPD Help Desk will be closed on Thursday, November 25, 2021 due to the Thanksgiving holiday.  The MAPD Help Desk will be open from 8:00 AM until 4:00 PM (ET) the following day on Friday, November 26, 2021.  The MAPD Help Desk will resume operating under its usual hours of 8:00 AM through 6:00 PM (ET) on Monday, November 29, 2021.   

  • November 12, 2021 – MARx UI Availability on Friday, November 12 and Saturday, November 13, 2021

Due to system maintenance early completion, please see below for the MARx UI availability schedule for Friday, November 12 and Saturday, November 13, 2021:

o   6:00 AM - 9:30 PM ET on Friday, November 12:  Available in UPDATE mode

o   9:30 PM on Friday, November 12 - 6:00 AM ET on Saturday, November 13:  Available in READ mode

o   6:00 AM - 9:30 PM ET on Saturday, November 13:  Available in UPDATE mode

Additionally, Plan transaction processing resumed at 6:00 AM ET on Friday, November 12. MARx submitters will start receiving the Batch Completion Status Summary (BCSS) Reports on Friday, November 12 and Plan users will receive the Daily Transaction Reply Report (DTRR) on Saturday, November 13.

  • November 4, 2021 – MARx UI Availability from Friday, November 5 – Thursday, November 11, 2021

Due to system maintenance, please see below for the MARx UI availability schedule for Friday, November 5 through Thursday, November 11:

o   6:00 AM - 8:00 PM ET on Friday, November 5:  Available in UPDATE mode

o   8:00 PM on Friday, November 5 - 11:30 PM ET on Saturday, November 6:  Available in READ mode

o   11:30 PM on Saturday, November 6 - 8:00 AM ET on Sunday, November 7:  Not Available

o   8:00 AM – 7:00 PM ET on Sunday, November 7:  Available in READ mode

o   7:00 PM on Sunday, November 7 - 12:30 AM ET on Monday, November 8:  Not Available

o   12:30 AM on Monday, November 8 - 6:00 AM ET on Saturday, November 13:  Available in READ mode

o   6:00 AM – 9:30 PM ET on Saturday, November 13:  Available in UPDATE mode

Additionally, please be advised that Plan transaction processing will be stopped at 8:00 PM on Friday, November 5 until 9:00 PM ET Friday, November 12. Users will not receive Batch completion reports during this time. Plan users will not receive a Daily Transaction Reply Report (DTRR) on Sunday, November 7 through Saturday, November 13. The next DTRR transmission distribution after Saturday, November 6 will be on Sunday, November 14.

  • November 1, 2021 – MARx UI Availability on Monday, November 1 – Wednesday November 3, 2021

Due to planned system maintenance, please see below for the MARx UI availability schedule for Monday, November 1 through Wednesday November 3, 2021:

o   6:00 AM - 9:30 PM ET on Monday, November 1:  Available in UPDATE mode

o   9:30 PM on Monday, November 1 - 2:00 PM ET on Wednesday, November 3Available in READ mode

o   2:00 PM – 9:30 PM ET: on Wednesday, November 3:  Available in UPDATE mode

Additionally, Plan transaction processing will be stopped at 9:00 PM on Monday, November 1 until 2:00 PM ET, Wednesday November 3. Users will not receive Batch completion reports during this timePlans will not receive a Daily Transaction Reply Report (DTRR) on Wednesday, November 3. The next Daily Transaction Reply Report (DTRR) after Tuesday, November 2 will be on Thursday, November 4.

  • October 29, 2021 – October 2021 Plan Communications User Guide v15.4 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (version 15.4) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website.  Updates to the Guide reflect changes to Section 7: Outbound Files and Miscellaneous, and Section 8.7: Reporting Beneficiaries Identified within a Drug Management Program. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

  • October 22, 2021 – MARx UI Availability for Friday, October 22 and Saturday, October 23, 2021

Due to system maintenance, please see below MARx UI availability schedule for Friday, October 22 and Saturday, October 23:

o  10:00 PM on Friday, October 22 – 12:00 AM ET on Saturday, October 23 Not Available

  • October 19, 2021 – MARx UI Availability on Tuesday, October 19, 2021

Due to planned system maintenance, please see below for the MARx UI availability schedule for Tuesday, October 19, 2021:

o   6:00 AM - 3:00 PM ET:  Available in UPDATE mode; early cut-off time due to maintenance

o   3:00 PM - 5:00 PM ET:  Not Available

o   5:00 PM - 9:30 PM ET:  Available in UPDATE mode

  • October 18, 2021 – MARx UI Availability on Monday, October 18, 2021

Due to planned system maintenance, please be advised that the MARx UI will be unavailable from 9:00 PM until 11:00 PM ET on Monday, October 18, 2021.

  • October 14, 2021 – MARx UI Availability on Saturday, October 16 and Sunday, October 17, 2021

Due to system maintenance, please see below for the MARx UI availability schedule for Saturday, October 16 through Sunday, October 17, 2021:

o   8:00 PM - 11:00 PM ET on Saturday, October 16:  Available in READ mode

o   11:00 PM on Saturday, October 16 - 8:00 AM ET on Sunday, October 17:  Not Available

Additionally, Plan transaction processing will be stopped at 7:30 PM ET on Saturday, 10/16. Plans will receive the Daily Transaction Reply Report (DTRR) on Sunday, 10/17, after 8:00 AM.

  • October 1, 2021 – MARx UI Availability from Saturday, October 2 – Sunday, October 3, 2021

Due to system maintenance, please see below for the MARx UI availability schedule for Saturday, October 2 through Sunday, October 3, 2021:

o   6:00 AM - 8:00 PM ET on Saturday, October 2:  Available in UPDATE mode

o   8:00 PM on Saturday, October 2 - 6:00 AM ET on Sunday, October 3:  Available in READ mode

o   6:00 AM – 11:00 AM ET on Sunday, October 3:  Not Available

Additionally, Plan transactions processing will be stopped at 7:30 PM on Saturday, October 2.

  • April 28, 2021 Announcement of the July 24, 2021 Software Release

Please see the memorandum entitled “Announcement of the July 24, 2021 Software Release – Special Election Period (SEP) Reason Code” from Jerry Mulcahy, Director, Medicare Enrollment and Appeals Group, which is now available via the Software Release Announcements page. This memorandum provides notice of an upcoming enhancement to the Medicare Advantage Prescription Drug Program (MARx) System. This enhancement will require a MARx system user to select an SEP reason from a pre-populated drop down list of SEP Reason Codes anytime the Election Type Code ‘S’-Special Election Period is used for an enrollment or disenrollment transaction.

  • February 18, 2021  Updates to the eRPT Plan User Manual in Version 4.3

Starting February 22, 2021 - the Electronic Retroactive Processing Transmission (eRPT) is transitioning its user authentication mechanism from Enterprise Identity Management (EIDM) to Identity Management (IDM). Due to this transition, the eRPT Application Team had updated (or added) the following sections in the eRPT Plan User Manual:

  • 3.3.1 Registering in CMS Enterprise Portal
  • 3.3.2 Requesting Access to the eRPT Application
  • 3.3.3 Viewing Your Access to Existing/Pending Role
  • 3.3.4 Modifying Your Access
  • 3.3.5 Accessing eRPT Application from Within CMS Enterprise Portal
  • 3.3.6 Adding/Removing Additional MFA Devices
  • 3.3.7 Updating Your Security Question and Answer

Please note that eRPT will continue to be accessible through the CMS Enterprise Portal at https://portal.cms.gov/.

Your User ID, password, role in eRPT, and the eRPT functionality will not change. During login, the first time on or after February 22nd, your MFA device will default to email. Feel free to change your default MFA device upon logging in - the steps for which are defined in Section 3.3.6 of the manual. The updated eRPT Plan user manual (Version 4.3) will be available for access within the eRPT user interface on or after February 22, 2021.

If you have any questions or concerns, please contact MAPD HelpDesk at mapdhelp@cms.hhs.gov or 1-800-927-8069.

  • June 5, 2020 – Real-time Beneficiary Eligibility Query (BEQ) for Medicare Advantage and Part D Plans

Please review the memo entitled "Real-time Beneficiary Eligibility Query (BEQ) for Medicare Advantage and Part D Plans," from John Campbell (Technical Advisor, Division of Medicare Enrollment Coordination, Medicare Enrollment and Appeals Group, Center for Medicare) dated June 5, 2020, via the downloads section below.  The memo provides an overview of the new Beneficiary on the Cloud - Beneficiary Eligibility Query service implemented by the CMS.

  • May 19, 2020 MBI Plan Lookup Tool

Please see the memorandum (MBI Lookup Tool) from Jerry Mulcahy, Director, Medicare Enrollment Appeals Group in the Downloads section below. The purpose of this memorandum is to announce that CMS released the secure web-based Medicare Beneficiary Identifier (MBI) Plan lookup tool in the Medicare Advantage Prescription Drug System (MARx) on the M232 beneficiary eligibility screen. The MBI Plan lookup tool provides authorized users the ability to obtain an individual beneficiary’s MBI using specified search criteria.

  • April 9, 2020 – Flexibility Regarding the RPC EDV Monthly Review Process

The Centers for Medicare & Medicaid Services (CMS) is providing flexibility regarding the Retroactive Processing Contractor’s (RPC) Enrollment Data Validation (EDV) monthly review process.  

Effective immediately, flexibility will be provided regarding response documentation timeliness requirements for EDV Review Packages until further notice.  Please note that the monthly EDV Review Packages will continue to post, as scheduled, on the electronic Retroactive Processing Transmission (eRPT) Post Date outlined on the Reed & Associates website.  A link to the schedule is located here: https://protect2.fireeye.com/url?k=349c5415-68c87d3e-349c652a-0cc47a6d17cc-f3fd9c1d3d1c34ab&u=http://www.reedassociates.org/enrollment-data-validation-services/.  Although timeliness requirements are waived during this period, please continue to upload response documentation as close to the due date as possible.

  • February 19, 2020 - Quick Reference Guide (QRG) MAPD Help Desk Common Issues

The MAPD Help Desk receives thousands of inquiries each month and in an effort to better assist our growing user community, we have consolidated information regarding issues we most commonly support.  Please refer to the Quick Reference Guide of MAPD Help Desk Common Issues in the download section below which provides users with easy access to common issues and solutions in a quick and easy format.

Topics covered include:

  • Initial Setup
  • Remote Identity Proofing (RIDP)
  • Account Issues
  • June 19, 2019 – Important Notice Regarding End Stage Renal Disease (ESRD) Payment Cases

In an effort to expedite the processing of ESRD payment cases, effective immediately, all Plans will be required to call into the Quality Net Help Desk to open an ESRD trouble ticket.  The MAPD Help Desk and the Division of Payment Operations (DPO) will no longer be taking calls or tickets relating to ESRD missing payments.  Please note that this is ONLY for cases where an ESRD period is incorrect or missing thereby causing incorrect payments.  All other ESRD issues, including transplant cases, should still be reported to DPO through the MAPD Help Desk. 

ESRD tickets already sent to the MAPD Help Desk have been evaluated by DPO and processed via the Center for Clinical Standards and Quality’s (CCSQ) CrownWeb system. ESRD periods that were corrected will calculate proper payment adjustments and will be applied in an upcoming payment cycle.  ESRD periods that were rejected will need the assistance of the CCSQ to perform additional follow up. 

Going forward, Plans are encouraged to contact the Quality Net Help Desk with new cases and follow up questions on previously closed ESRD tickets which may require additional help.   Please direct all questions or concerns to the Quality Net Help Desk at 1-866-288-8912 or email at qnetsupport@sdps.org.

  • March 26, 2019 – Guidance for PDP/MA/MAPDs to Correct MA-OEP Election Type Code Rejections

Please review the memo entitled “Guidance to Correct MA-OEP Election Type Code Rejections” in the Downloads section below for information regarding recent issues within the MARx system for Plans using the MA-OEP election type.

  • Important Notice: MAPD Help Desk Information Request Documents

Please use the MAPD Help Desk Information Request Form, and when applicable the Health Insurance Claim Number (HICN) – Medicare Beneficiary Identifier (MBI) Template, and the End Stage Renal Disease (ESRD) Template when requesting information from the MAPD Help Desk.  Use of the form and spreadsheets will help facilitate accurate and timely processing of your request.  Please note that if emailing the spreadsheets they are to be password protected to ensure they are following the CMS Security Policy for PHI/PII.

All documents are provided in the Downloads section in the ZIP file entitled MAPD Help Desk Information Request Documents.

 

Regularly Scheduled Maintenance

As a reminder, the MARx UI may be unavailable due to Regularly Scheduled Maintenance during the following timeframes:

Daily: 11:00 PM to 12:30 AM ET.

Weekly: Sunday evening at 6:00 PM to Monday morning at 6:00 AM ET.

Also, GENTRAN/TIBCO may be unavailable due to Weekly System Backup during the following timeframe:

Weekly: Sunday Morning at 1:00 AM to approximately 3:00 AM ET.

 

MARx UI Submission Cut Off Dates

Please reference the following table for the 2020 Plan Data Due dates for MARx transaction submissions.  Cutoff for the submission of MARx transaction files is 8:00 PM (Eastern Time) on the dates listed below:

Payment Month Plan Data Due Date
January 2021 December 4, 2020
February 2021 January 8, 2021
March 2021 February 5, 2021
April 2021 March 5, 2021
May 2021 April 9, 2021
June 2021 May 7, 2021
July 2021 June 4, 2021
August 2021 July 9, 2021
September 2021 August 6, 2021
October 2021 September 10, 2021
November 2021 October 8, 2021
December 2021 November 5, 2021
January 2022 December 3, 2021
February 2022 January 7, 2022

 

 

Contacting the MAPD Help Desk

Phone: 1-800-927-8069
E-mail: mapdhelp@cms.hhs.gov
Hours of Operation: Monday-Friday 8:00 AM to 6:00 PM ET.

Page Last Modified:
11/18/2021 01:46 PM