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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

  • September 12, 2019 – MARx UI Availability on Saturday, September 14 - Sunday, September 15, 2019

Due to planned system activities, please review the MARx UI schedule below for Saturday, September 14  - Sunday, September 15, 2019:

o MARx UI will be in update mode from 6:00 AM (ET) – 8:00 PM (ET) on Saturday, September 14
o MARx UI will be in read mode from 8:00 PM (ET) – 11:30 PM (ET) on Saturday, September 14
o MARx UI will be unavailable from 11:30 PM (ET) Saturday, September 14 – 8:00 AM (ET) on Sunday, September 15

  • September 5, 2019 – MARx UI Availability on Sunday, September 8, 2019

Due to planned system activities, please be advised that the MARx UI will be unavailable from 12:00 AM – 4:00 AM (ET) on Sunday, September 8, 2019.

  • August 30, 2019 – Plan Communications User Guide (Version 13.2) Now Available

The Centers for Medicare & Medicaid Services has posted a new version (version 13.2) of the Plan Communications User Guide to the MAPD Help Desk website.  Enhancements to the Guide reflect changes incorporated from the August 2019 Release.  Please reference the MAPD Plan Communications User Guide (PCUG) link for the updated Guide.

  • September 1, 2019 – MARx UI Availability on Sunday, September 1, 2019

Due to planned system activities, please be advised that the MARx UI will be unavailable from 8:00 AM – 12:00 PM (ET) on Sunday, September 1, 2019.

  • August 27, 2019 – MAPD Help Desk Closed on Labor Day, Monday, September 2, 2019

Please be advised that the MAPD Help Desk will be closed on Monday, September 2, 2019 due to the Labor Day holiday.  The MAPD Help Desk will resume operating under its usual hours of 8:00 AM through 6:00 PM (ET) on Tuesday, September 3, 2019.

  • August 21, 2019 – MARx UI availability on Friday, August 23 - Monday, August 26, 2019

Due to 2018 Second Final Year Risk Adjustment Reconciliation processing, please review the information below regarding the MARx UI schedule for Friday, August 23 - Monday, August 26, 2019:

o MARx UI will be in update mode from 6:00 AM (ET) – 6:00 PM (ET) Friday, August 23.
o MARx UI will be in read-only mode from 6:00 PM (ET) Friday, August 23 – 11:59 AM (ET) Saturday, August 24.
o MARx UI will be unavailable from 12:00 AM (ET) – 4:00 AM (ET) Sunday, August 25.
o MARx UI will be in read-only mode from 12:30 AM (ET) – 11:59 AM (ET) Monday, August 26.

In addition, Plan transactions processing will be stopped at 6:00 PM (ET) on Friday, August 23 until 12:00 PM (ET ) Monday, August 26; users will not receive Batch Completion Reports during this time.  Plan users will not receive a Daily Transaction Reply Report (DTRR) on Sunday, August 25. The next DTRR after Saturday, August 24 will be on Tuesday, August 27.

  • August 15, 2019 – MARx UI Availability on Saturday, August 17 - Sunday, August 18, 2019

Due to planned system activities, please review the MARx UI schedule below for Saturday, August 17  - Sunday, August 18, 2019:

o MARx UI will be unavailable from 12:00 AM (ET) – 6:00 AM (ET) on Saturday, August 17
o MARx UI will be in update mode from 6:00 AM (ET) – 8:00 PM (ET) on Saturday, August 17
o MARx UI will be read-only mode from 8:00 PM (ET) – 11:30 PM (ET) Saturday, August 17
o MARx UI will be unavailable from 11:30 PM (ET) Saturday, August 17 – 8:00 AM (ET) on Sunday, August 18
o MARx UI will be read-only mode from 8:00 AM (ET) – 7:00 PM (ET) on Sunday, August 18

  • August 1, 2019 – MARx UI Availability on Sunday, August 4, 2019

Due to planned system activities, please be advised that the MARx UI will be unavailable from 12:00 AM – 4:00 AM (ET) on Sunday, August 4, 2019.

  • July 30, 2019 – Announcement of the August 2019 Software Release

Please review the memorandum entitled "Announcement of the August 2019 Software Release," from Jennifer R. Shapiro (Acting Director, Medicare Plan Payment Group) and Cathy Carter (Director, Enterprise Systems Solutions Group) dated July 29, 2019, via the Software Release Announcements link.  The memo provides information regarding the Medicare Advantage Prescription Drug software changes, which are scheduled for implementation in August 2019.

  • 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.

  • June 7, 2019 – Electronic Retroactive Processing Transmission (eRPT) Plan User Manual v4.0

The eRPT Plan User Manual v4.0 has been posted to the Downloads section below. This version of the user manual captures the new look of the eRPT application integrated with the CMS Enterprise Portal. There are no changes to the core business functionality of the eRPT Application. The user experience of the eRPT application has been made compliant with the CMS mandated Section 508 Standards for accessibility of Electronic and Information Technology (EIT), which requires that the EIT must allow Federal employees and individuals of the public with disabilities comparable access to and use of information and data that is provided to Federal employees and individuals of the public without disabilities.

  • May 31, 2019 – Plan Communications User Guide (Version 13.1) Now Available

The Centers for Medicare & Medicaid Services has posted a new version (version 13.1) of the Plan Communications User Guide to the MAPD Help Desk website.  Enhancements to the Guide reflect changes incorporated from the May 2019 Release.  Please reference the MAPD Plan Communications User Guide (PCUG) link for the updated Guide.

  • 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.

  • August 3, 2018 – MARx UI Integration with CMS Enterprise Portal Effective August 12, 2018

Effective Sunday, August 12, 2018, access to the MARx UI will be through the CMS Enterprise Portal at https://portal.cms.gov.  Users will no longer access the MARx UI via https://marx.cms.hhs.gov.  Please refer to the MARx UI-Enterprise Portal Integration Quick Reference Guide in the Download section below.

  • Year 2019 MARx Plan Monthly Calendar Now Available

The MARx Plan Monthly Calendar has been updated to reflect 2019 Plan data due dates, report release dates, enrollment certification due dates, and file transmissions. The 2019 MARx calendar is available for Plans to review via the MAPD/MARx Calendars and Schedules link.

  • 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 2019 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 2019 December 7, 2018
February 2019 January 4, 2019
March 2019 February 8, 2019
April 2019 March 8, 2019
May 2019 April 5, 2019
June 2019 May 10, 2019
July 2019 June 7, 2019
August 2019 July 5, 2019
September 2019 August 9, 2019
October 2019 September 6, 2019
November 2019 October 4, 2019
December 2019 November 8, 2019

 

 

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.