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

  • 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 25, 2020 – MARx UI availability on Saturday, September 26 and Sunday, September 27, 2020

Due to system maintenance, please review the information below regarding the MARx UI schedule for Saturday, September 26 and Sunday, September 27 2020:

o MARx UI will be unavailable from 12:00 AM  –  6:00 AM (ET) Saturday,  September 26.

o MARx UI will be unavailable from 12:00 AM  –  8:30 AM (ET) Sunday,  September 27.

  •  September 23, 2020 – MARx UI availability on Wednesday, September 23 – Thursday, September 24, 2020

Due to system maintenance, please review the information below regarding the MARx UI schedule for Wednesday, September 23 – Thursday, September 24 2020:

o  MARx UI will be unavailable from 9:00 PM Wednesday, September 23 –  3:00 AM (ET) Thursday,  September 24.

  • September 18, 2020 - MARx UI availability on Saturday, September 19 - Sunday, September 20, 2020

Due to system maintenance, please review the information below regarding the MARx UI schedule for Saturday, September 19 - Sunday, September 20, 2020:

o MARx UI will be unavailable from 10:00 AM – 12:00 PM (ET) Saturday, September 19

o MARx UI will be in update mode from 12:00 PM – 8:00 PM (ET) Saturday, September 19

o MARx UI will be in read mode from 8:00 PM – 11:30 PM (ET) Saturday, September 19

o MARx UI will be in unavailable from 11:30 PM Saturday, September 19 – 8:00 AM (ET) Sunday, September 20.

Also, Plans will receive the Daily Transaction Reply Report (DTRR) on Sunday, September 20, after 8:00 AM (ET).

  • 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.

  • September 11, 2020 – MARx UI availability on Sunday, September 13, 2020

Due to system maintenance, please review the information below regarding the MARx UI schedule for Sunday, September 13, 2020:

o  MARx UI will be unavailable from 12:00 AM – 4:00 AM (ET) Sunday, September 13.

  • August 31, 2020 Updated May 2020 Plan Communications User Guide v14.2 Now Available

The Centers for Medicare & Medicaid Services has reissued a new version (version 14.2) of the May 2020 Plan Communications User Guide (PCUG), which is now available on the MAPD Help Desk website.  Updates to the Guide reflect corrections to Transaction Reply Code (TRC) types in the Enrollment and Eligibility TRC Grouping table and the Premium TRC Grouping table.  Please note that no changes were added to TRC definitions in this reissued version of the PCUG.  Please reference the Change Log at the beginning of the Guide for a list of the updates, and visit the MAPD Plan Communications User Guide (PCUG) page for the updated Guide.

  • 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:
10/05/2020 01:29 PM