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.
  • EIDM - Enterprise 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 25, 2020 – MARx UI availability from Friday, November 27 – Sunday, November 29, 2020

Due to system maintenance, please see below for the MARx UI availability schedule between Friday, November 27, and Sunday, November 29:

       o   9:30 PM on Friday, November 27 - 7:00 PM ET on Sunday, November 29, 2020:  Available in READ mode

Additionally, please be advised that Plan transaction processing will be stopped at 9:00 PM on Friday, November 27 until 9:00 PM ET Saturday, November 28. Users will not receive Batch completion reports during this time. Plan users will not receive a Daily Transaction Reply Report (DTRR) on Sunday, November 29; the next DTRR transmission after Saturday, November 28 will be on Tuesday, December 1.

  • November 19, 2020 – MARx UI Availability on Sunday, November 22, 2020

Due to planned system maintenance, please be advised that the MARx UI will be unavailable from 12:00 AM until 3:30 AM ET on Sunday, November 22.

  • November 19, 2020 MAPD Help Desk Closed on Thanksgiving Day, Thursday, November 26, 2020

Please be advised that the MAPD Help Desk will be closed on Thursday, November 26, 2020 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 27, 2020.  The MAPD Help Desk will resume operating under its usual hours of 8:00 AM through 6:00 PM (ET) on Monday, November 30, 2020.

  • November 13, 2020 – MARx UI Availability on Saturday, November 14, 2020

Due to planned system activities, please review the MARx UI schedule below for Saturday, November 14, 2020:

        o   MARx UI will be unavailable from 10:00 AM – 12:00 PM (ET) Saturday, November 14.

  • November 10, 2020 – MARx UI availability from Friday, November 6 – Thursday, November 12, 2020 

Due to system maintenance, please see below for the MARx UI availability schedule between Friday, November 6, and Thursday, November 12:

o   6:00 AM - 8:00 PM ET on Friday, November 6:  Available in UPDATE mode
o   8:00 PM on Friday, November 6 - 11:30 AM ET on Saturday, November 7, 2020:  Available in READ mode
o   11:30 AM - 2:30 PM ET on Saturday, November 7, 2020:  Not Available
o   2:30 PM Saturday, November 7, 2020 - 6:00 PM ET on Sunday, November 8:  Available in READ mode
o   6:00 PM Sunday, November 8 - 12:30 AM ET on Monday, November 9:  Not Available
o   12:30 AM Monday, November 9 - 2:00 PM ET on Thursday, November 12:  Available in READ mode
o   2:00 PM – 9:30 PM on Thursday, November 12:  Available in UPDATE mode
 

Additionally, please be advised that Plan transaction processing will be stopped at 8:00 PM on Friday, November 6 until 2:00 PM ET Thursday, 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 8 through Thursday, November 12; the next DTRR transmission after Saturday, November 7 will be on Friday, November 13.

  • October 30, 2020 – October 2020 Plan Communications User Guide v14.3 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (version 14.3) Plan Communications User Guide, which is now available on the MAPD Help Desk website.  Enhancements to the Guide reflect the changes for October 2020; please reference the Change Log at the beginning of the Guide for a list of the updates.  Please reference the MAPD Plan Communications User Guide (PCUG) link for the updated Guide.

  • November 4, 2020 – Update to MARx UI availability from Saturday, October 31 – Wednesday, November 4, 2020

Due to system maintenance and New Year Preparation activities, please see below for the MARx UI availability schedule between Saturday, October 31, and Wednesday, November 4:

o   12:00 AM - 4:00 AM ET on Saturday, October 31Not available
o   4:00 AM - 6:00 AM ET on Saturday, October 31Available in READ mode
o   6:00 AM - 8:00 PM ET on Saturday, October 31, 2020:  Available in UPDATE mode
o   8:00 PM - 11:30 PM ET on Saturday, October 31Available in READ mode
o   11: 30 PM on Saturday, October 31 - 8:00 AM ET on Sunday, November 1:  Not Available
o   8:00 AM - 7:00 PM ET on Sunday, November 1Available in READ mode
o   7:00 PM on Sunday, November 1 - 12:30 AM ET on Monday, November 2Not available
o   12:30 AM - 6:00 AM ET on Monday, November 2Available in READ mode
o   6:00 AM - 9:30 PM on Monday, November 2Available in UPDATE mode
o   9:30 PM on Monday, November 2 - 5:00 PM ET on Wednesday, November 4Available in READ mode
o   5:00 PM - 9:30 PM ET on Wednesday, November 4Available in UPDATE mode
 

Additionally, please be advised that Plan transaction processing will be stopped at 9:00 PM on Monday, November 2 until 6:00 PM ET Wednesday, November 4. Users will not receive Batch completion reports during this time. Plan users will not receive a Daily Transaction Reply Report (DTRR) on Wednesday, November 4; the next DTRR transmission after Tuesday, November 3 will be on Thursday, November 5.

  • October 5, 2020 – Year 2021 MARx Plan Monthly Calendar Now Available

The MARx Plan Monthly Calendar has been updated to reflect 2021 Plan data due dates, report release dates, enrollment certification due dates, and file transmissions. The 2020 MARx calendar is available for Plans to review via the MAPD/MARx Calendars and Schedules link

  • September 17, 2020 – Updates to Electronic Retroactive Processing Transmission (eRPT) Plan User Manual in v4.2

Version 4.2 of the eRPT Plan User Manual is now available in the Downloads section below. On 09/21/2020, a new “Plan Enrollment Data Validation (EDV) Report” reports functionality has been introduced in the eRPT application system. In this version of the User Manual, “Section 4.2.3 Download Plan EDV Reports” has been added with details on how to access the new ‘Plan EDV Report’ through the eRPT User Interface. The Retroactive Processing Contractor (RPC) Team will initiate the process of posting the “Plan EDV Report” for the Plan to review. The report will be contract specific, and only the Plans who do have access to that specific contract will be able to view and download the “Plan EDV Report.” An email and a system notification will be sent to the respective Plans who have access to the contract(s) when the reports are made available in eRPT. This specific section in the user manual details the steps involved for a Plan User to view and download these reports through the eRPT user interface, when available.

If you have any questions or concerns about this new report, or how to access it, please contact MAPD Help Desk 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 2020 December 6, 2019
February 2020 January 3, 2020
March 2020 February 7, 2020
April 2020 March 6, 2020
May 2020 April 10, 2020
June 2020 May 8, 2020
July 2020 June 5, 2020
August 2020 July 10, 2020
September 2020 August 7, 2020
October 2020 September 11, 2020
November 2020 October 9, 2020
December 2020 November 6, 2020

 

 

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:
11/25/2020 01:46 PM