10-19-2023 As indicated in the recent release of Chapter 3 Section 40.1.5 F and the 2024 Reassignment of Low-Income Subsidy Beneficiaries in Prescription Drug Plans HPMS memo, requests for ‘Re Enrollment’ in the Losing Plan should be submitted to the Retroactive Processing Contractor (RPC).

In accordance with these changes, the RPC has updated the Documentation Requirements Matrix and provided a new LIS Re-Enrollment Documentation Worksheet. Both documents can be found in the RPC Submission Toolkit section of this website, linked below.

RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/

07-19-2023 The RPC has updated the Documentation Requirements Matrix in both the RPC Submission Toolkit and the Enrollment Data Validation Toolkit. These updates have been made to streamline the documentation requirements for PACE Disenrollments and PACE Enrollment Cancellations and to align more closely with the Programs of All-Inclusive Care for the Elderly (PACE), Chapter 4 – Enrollment and Disenrollment Manual.

Please follow the below links to access the updated documents.

• RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/
• Enrollment Data Validation Toolkit – https://www.reedassociates.org/enrollment-data-validation-toolkit/

06-6-2023 The Enrollment Transaction (TTC61), located in the Enrollment Data Validation Toolkit, has been updated to include a checkbox for Medicare.gov CMS Online Enrollment Center enrollments and a revision to the Online Enrollment Center to MAO/PDP Sponsor Online Enrollment Center. These updates have been made to add distinction between the two online enrollment centers. Please begin using this latest version at your earliest convenience.

05-15-2023 A revised RPC Submission Spreadsheet has been uploaded to the RPC Submission Toolkit page. The revision includes the latest SEP Reason Codes for the SEP S Election Type Code. The latest version can be found through the link below; please begin using it at your earliest convenience.
https://www.reedassociates.org/rpc-submission-toolkit/

If you have any questions regarding these changes, please contact our Client Services department at clientservices@reedassociates.org.

03-16-2023 The EDV Dispute Form located in the Enrollment Data Validation Toolkit page has been updated to include instructions on how to submit the EDV Dispute directly to the RPC. Please begin using this latest version at your earliest convenience.

02-08-2023 Starting with results posted in February 2023, plans may begin submitting EDV Disputes directly to the RPC following the process outlined in the Enrollment Data Validation (EDV) SOP.
To facilitate this process the RPC has updated the Enrollment Data Validation (EDV) Services section of our website.

Please follow the below link to access the updated documents.

Enrollment Data Validation SOP – Enrollment Data Validation SOPs.

Enrollment Data Validation Toolkit – Enrollment Data Validation Toolkit.

10-18-2022 The EDV Dispute form on the Enrollment Data Validation Toolkit page has been redesigned to accommodate multiple transactions within the EDV Dispute.  We have also added a field to include the applicable CMS Guidance used to support the dispute.  Please begin using this latest version at your earliest convenience.

6-26-2022 In HPMS memos dated November 2, 2021, and June 9, 2022, CMS announced the June 26, 2022, software release – Disenrollment for Individuals Who Are Incarcerated in the United States and Disenrollment for Individuals Who Are Not Lawfully Present in the United States.

Beginning on July 26th, 2022, CMS plans to disenroll individuals who are Incarcerated in the United States and individuals who are Not Lawfully Present in the United States in accordance with eligibility requirements codified in 42 CFR §§ 417.422, 422.50, and 423.30.

In accordance with these changes, the RPC has updated the Documentation Requirements Matrix in the RPC Submission Toolkit section and the Documentation Requirements Matrix in the Enrollment Data Validation (EDV) Services section of our website.

Please follow the below links to access the updated documents.

RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/

Enrollment Data Validation Toolkit – https://www.reedassociates.org/enrollment-data-validation-toolkit/

6-21-2022 Due to routine maintenance, a revised RPC Submission Spreadsheet has been uploaded to the Reed & Associates website. We request that you begin using this latest version at your earliest convenience.

5-6-2022 The RPC has updated the Standard Operating Procedures (SOP) on the Reed & Associates, CPAs website – https://www.reedassociates.org/cms-rpc/ . These updates were performed to streamline the instruction for submission of retroactive requests and validation documentation to the RPC. Documents included in this update are:

Retroactive Enrollment & Disenrollment SOP
Retroactive State & County Code (SCC) Changes SOP
Medicaid Status Changes SOP
Retroactive State & Enrollment Broker SOP
Enrollment Data Validation (EDV) SOP

The Point of Contact (POC) Form on the Client Services page was updated to remove the RPC mailing address for POC updates, as email is the preferred method for submission of these updates.

3-28-2022 A revised RPC Submission Spreadsheet has been uploaded to the RPC Submission Toolkit page. The revision ensures all SEP Reason Codes are available for the selected Group Code.

3-22-2022 Website Updates! The RPC Submission Spreadsheet has been updated to add dropdowns to accommodate the required SEP (S) Group and Reason Codes. The E&D Documentation Worksheets have been updated to streamline submission of the required elements. The EDV Documentation Worksheets have also been updated to streamline submission of the required elements. Please note that a new worksheet has been added for the MMP Enrollment Cancellation (TC82) transaction type.

1-26-2022 RPC Documentation Requirements Matrix – UPDATED! The matrix has been updated to provide more detailed information on the requirements for the MMP Demonstration Plans Voluntary Disenrollment request, Disenrollments due to Loss of Parts A/B/D Entitlement, and Enrollments & PBP Changes requiring Retiree Drug Subsidy Override.

1-26-2022 EDV Documentation Requirements Matrix – UPDATED! The matrix has been updated to provide more detailed information on the requirements for the MMP Demonstration – Beneficiary Elected Enrollment Cancellation (TTC 82) transactions and Enrollments and PBP Changes requiring Retiree Drug Subsidy Override.

10-25-2021 EDV Disposition Codes – UPDATED! The v529 Disposition Code explanation has been updated for EDV transactions. The explanation has been broadened to include that the documentation submitted was named with an invalid naming convention.

10-08-2021 EDV Documentation Requirements Matrix – UPDATED!
The matrix has been updated to include more detailed requirements for the Enrollment Data Validation.

10-08-2021 RPC Documentation Requirements Matrix – UPDATED!
The matrix has been updated to include more detailed requirements for E&D & PayVal submissions.

9-29-2021 Submission Spreadsheet UPDATED
RPC Submission Spreadsheet updated to include R – 5 Star Special Election Period (SEP)

9-16-2021 Submission Spreadsheet UPDATED
The RPC has updated the Submission Spreadsheet in the RPC Submission Toolkit section of our website. This change aligns the Election Period dropdown within the spreadsheet to include those listed in the September 2021 PCUG and the MARx application. A link to the updated spreadsheet is included above. The spreadsheet is also updated within the RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/
Please begin utilizing the updated document at your earliest convenience.

9-10-2021 Plan EDV Reports – FAQ – NEW!

9-9-2021 FDR Code Definitions – UPDATED!

7-29-2021 RPC Submission Spreadsheet – UPDATED!

7-23-2021 RPC Submission Spreadsheet – UPDATED!
In an HPMS memo dated April 27th, 2021, CMS announced the implementation of software changes to the enrollment and payment systems that support MA, MAPD, PDP, Cost, PACE, and Demonstration plans regarding the use of SEP election periods.
Beginning on July 24th, 2021, the Medicare Advantage Prescription Drug System (MARx) will be enhanced to include the following new fields for enrollment and disenrollment transactions:
SEP Reason Code Group (MARx UI Only)
SEP Reason Code
In accordance with these changes, the RPC has updated the documents in the RPC Submission Toolkit section of our website. Below is a link to the location of the updated documents.
RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/
Please begin utilizing the updated documents at your earliest convenience.
Plans are encouraged to contact the MAPD Help Desk for any issues encountered during the systems update process. Please direct any questions or concerns to the MAPD Help Desk at 1-800-927-8069 or e-mail mapdhelp@cms.hhs.gov.

5-21-2021 EDV Disposition Codes – UPDATED!

4-8-2021 EDV Disposition Codes – NEW!

3-15-2021 LIS Standard Operating Procedures – UPDATED!

3-1-2021 Additional Final Disposition Codes – NEW!

For information about the availability of auxiliary aids and services, please visit:

http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.

If you have any questions regarding these changes, please contact our Client Services department at clientservices@reedassociates.org.

10-18-2022 The EDV Dispute form on the Enrollment Data Validation Toolkit page has been redesigned to accommodate multiple transactions within the EDV Dispute.  We have also added a field to include the applicable CMS Guidance used to support the dispute.  Please begin using this latest version at your earliest convenience.

6-26-2022 In HPMS memos dated November 2, 2021, and June 9, 2022, CMS announced the June 26, 2022, software release – Disenrollment for Individuals Who Are Incarcerated in the United States and Disenrollment for Individuals Who Are Not Lawfully Present in the United States.

Beginning on July 26th, 2022, CMS plans to disenroll individuals who are Incarcerated in the United States and individuals who are Not Lawfully Present in the United States in accordance with eligibility requirements codified in 42 CFR §§ 417.422, 422.50, and 423.30.

In accordance with these changes, the RPC has updated the Documentation Requirements Matrix in the RPC Submission Toolkit section and the Documentation Requirements Matrix in the Enrollment Data Validation (EDV) Services section of our website.

Please follow the below links to access the updated documents.

RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/

Enrollment Data Validation Toolkit – https://www.reedassociates.org/enrollment-data-validation-toolkit/

6-21-2022 Due to routine maintenance, a revised RPC Submission Spreadsheet has been uploaded to the Reed & Associates website. We request that you begin using this latest version at your earliest convenience.

5-6-2022 The RPC has updated the Standard Operating Procedures (SOP) on the Reed & Associates, CPAs website – https://www.reedassociates.org/cms-rpc/ . These updates were performed to streamline the instruction for submission of retroactive requests and validation documentation to the RPC. Documents included in this update are:

Retroactive Enrollment & Disenrollment SOP
Retroactive State & County Code (SCC) Changes SOP
Medicaid Status Changes SOP
Retroactive State & Enrollment Broker SOP
Enrollment Data Validation (EDV) SOP

The Point of Contact (POC) Form on the Client Services page was updated to remove the RPC mailing address for POC updates, as email is the preferred method for submission of these updates.

3-28-2022 A revised RPC Submission Spreadsheet has been uploaded to the RPC Submission Toolkit page. The revision ensures all SEP Reason Codes are available for the selected Group Code.

3-22-2022 Website Updates! The RPC Submission Spreadsheet has been updated to add dropdowns to accommodate the required SEP (S) Group and Reason Codes. The E&D Documentation Worksheets have been updated to streamline submission of the required elements. The EDV Documentation Worksheets have also been updated to streamline submission of the required elements. Please note that a new worksheet has been added for the MMP Enrollment Cancellation (TC82) transaction type.

1-26-2022 RPC Documentation Requirements Matrix – UPDATED! The matrix has been updated to provide more detailed information on the requirements for the MMP Demonstration Plans Voluntary Disenrollment request, Disenrollments due to Loss of Parts A/B/D Entitlement, and Enrollments & PBP Changes requiring Retiree Drug Subsidy Override.

1-26-2022 EDV Documentation Requirements Matrix – UPDATED! The matrix has been updated to provide more detailed information on the requirements for the MMP Demonstration – Beneficiary Elected Enrollment Cancellation (TTC 82) transactions and Enrollments and PBP Changes requiring Retiree Drug Subsidy Override.

10-25-2021 EDV Disposition Codes – UPDATED! The v529 Disposition Code explanation has been updated for EDV transactions. The explanation has been broadened to include that the documentation submitted was named with an invalid naming convention.

10-08-2021 EDV Documentation Requirements Matrix – UPDATED!
The matrix has been updated to include more detailed requirements for the Enrollment Data Validation.

10-08-2021 RPC Documentation Requirements Matrix – UPDATED!
The matrix has been updated to include more detailed requirements for E&D & PayVal submissions.

9-29-2021 Submission Spreadsheet UPDATED
RPC Submission Spreadsheet updated to include R – 5 Star Special Election Period (SEP)

9-16-2021 Submission Spreadsheet UPDATED
The RPC has updated the Submission Spreadsheet in the RPC Submission Toolkit section of our website. This change aligns the Election Period dropdown within the spreadsheet to include those listed in the September 2021 PCUG and the MARx application. A link to the updated spreadsheet is included above. The spreadsheet is also updated within the RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/
Please begin utilizing the updated document at your earliest convenience.

9-10-2021 Plan EDV Reports – FAQ – NEW!

9-9-2021 FDR Code Definitions – UPDATED!

7-29-2021 RPC Submission Spreadsheet – UPDATED!

7-23-2021 RPC Submission Spreadsheet – UPDATED!
In an HPMS memo dated April 27th, 2021, CMS announced the implementation of software changes to the enrollment and payment systems that support MA, MAPD, PDP, Cost, PACE, and Demonstration plans regarding the use of SEP election periods.
Beginning on July 24th, 2021, the Medicare Advantage Prescription Drug System (MARx) will be enhanced to include the following new fields for enrollment and disenrollment transactions:
SEP Reason Code Group (MARx UI Only)
SEP Reason Code
In accordance with these changes, the RPC has updated the documents in the RPC Submission Toolkit section of our website. Below is a link to the location of the updated documents.
RPC Submission Toolkit – https://www.reedassociates.org/rpc-submission-toolkit/
Please begin utilizing the updated documents at your earliest convenience.
Plans are encouraged to contact the MAPD Help Desk for any issues encountered during the systems update process. Please direct any questions or concerns to the MAPD Help Desk at 1-800-927-8069 or e-mail mapdhelp@cms.hhs.gov.

5-21-2021 EDV Disposition Codes – UPDATED!

4-8-2021 EDV Disposition Codes – NEW!

3-15-2021 LIS Standard Operating Procedures – UPDATED!

3-1-2021 Additional Final Disposition Codes – NEW!

For information about the availability of auxiliary aids and services, please visit:

http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.