This page contains additional information regarding the MAPD Program.
Plan Quick Reference Guide (QRG)
In response to questions frequently asked by Plans, the MAPD Help Desk has compiled a list of resources where the answers may be found. The Plan QRG is provided in the “Downloads” section below. Topics include:
- Resolving system errors
- Obtaining information on user accounts
- Updating Plan contact information
- Identifying enrollment file transmissions
- Obtaining enrollment system guidance
Relevant Information within the CMS Web site
Provided below is a list of relevant information both within the CMS Web site and on related Web sites for CMS external business partners. The links for each site are in the “Related Links” section.
- Health Plans-General Information: This site contains operational and regulatory information related to Medicare Advantage (MA) and Medicare Advantage-Prescription Drug (MA-PD) organizations, Cost-Based Plans, and stand-alone Prescription Drug Plans (PDPs).
- Medicare Managed Care Eligibility and Enrollment: This site contains enrollment information relevant to Medicare Advantage (MA) organizations and Cost Plans, including enrollment/disenrollment guidance and content related to the transmission of beneficiary enrollment and payment information to CMS.
- Medicare Prescription Drug Eligibility and Enrollment: This site contains enrollment information relevant to Prescription Drug Plans (PDPs), including enrollment/disenrollment guidance, content for Part D Plans receiving auto-enrollment, and guidance related to creditable coverage period determinations and the late enrollment penalty.
- Prescription Drug Plan Contracting: This site provides specific information of particular importance to Prescription Drug Plans (PDPs), including detailed information on PDP application/renewal requirements, marketing guidelines, formulary requirements, Coordination of Benefits (COB), Plan reporting and oversight, and other special guidance.
- Coordination of Benefits (COB) for Part D: This site provides background information, documentation, and forms related to the COB contract, which consolidates Medicare benefit coordination activities from various Medicare contractors to a single point of contact.
- Retiree Drug Subsidy (RDS) Program: This site serves as a comprehensive resource center for the Retiree Drug Subsidy (RDS) Program.
- TrOOP Facilitation Coordinator: The True Out of Pocket (TrOOP) Eligibility Facilitator Service (Enhanced E1) provides data and tools to assist pharmacists and pharmacies with processing beneficiary prescriptions.
- Customer Service and Support Center (CSSC): This site provides comprehensive information on the Risk Adjustment Processing System (RAPS) and the Prescription Drug Event (PDE).
- What's the Social Security Number Removal Initiative (SSNRI)?: This site provides information regarding the Social Security Number Removal Initiative and the planned replacement of the Health Insurance Claim Number (HICN) with the Medicare Beneficiary Identifier (MBI).