Medicare Advantage and Prescription Drug Program Resources: • 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). A link to this CMS site is provided under the Related Links Inside CMS section below. • Medicare Advantage Contracting & Part D Training: This site provides information on all CMS training seminars and conferences related to preparing, establishing, and maintaining a contract with CMS to operate a Medicare Managed Care Health Plan including prescription drug plan. A link to this CMS site is provided under the Related Links Inside CMS section below. • 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. A link to this CMS site is provided under the Related Links Inside CMS section below. • 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. A link to this CMS site is provided under the Related Links Inside CMS section below. • 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, plan reporting and oversight, and other special guidance. A link to this CMS site is provided under the Related Links Inside CMS section below. | Other Resources: • Beneficiary Eligibility Portal: The CMS Applications Portal is a gateway offered to CMS Business Partners to access a number of systems related to Medicare Advantage and Prescription Drug and other CMS programs. A CMS-issued user ID is required in order to access data via this portal. A link to this CMS site is provided under the Related Links Inside CMS section below. • Coordination of Benefits (Part D): This site provides background information, documentation, and forms related to the Coordination of Benefits (COB) contract, which consolidates Medicare benefit coordination activities from various Medicare contractors to a single point of contact. A link to this CMS site is provided under the Related Links Inside CMS section below. • Retiree Drug Subsidy (RDS) Program: This website serves as a comprehensive resource center for the Retiree Drug Subsidy (RDS) Program. A link to this website is provided under the Related Links Outside CMS section below. • 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. A link to this website is provided under the Related Links Outside CMS section below. • Customer Service and Support Center (CSSC): This website provides comprehensive information on the Risk Adjustment Processing System (RAPS) and the Prescription Drug Information Center (PDIC). A link to this website is provided under the Related Links Outside CMS section below. |
Email
Print