Date: June 3, 2015 To: Medicare Advantage Organizations, Part D Sponsors, Medicare-Medicaid Plans, Cost-based Plans, PACE Organizations, and Regional Office Account Managers From: Thomas Siedlik Assistant Program Director, Retroactive Processing Contractor (RPC) Reed & Associates, CPAs Inc. Subject: Discontinuation of the ESRD Review Process This memorandum is being sent in addition to the Advantage Prescription Drug “Medicare System (MARx) June 2015 Payment to HPMS on May 22, – INFORMATION” memo posted 2015. Effective immediately, when trying to reconcile ESRD statuses for beneficiaries, Plans are no longer required to submit transaction requests and supporting documentation to the RPC. If Plans have concerns or questions about ESRD payments or ESRD status a beneficiary’s change/update, please contact the MAPD Help Desk to open a Remedy ticket. A Division of Payment Operations (DPO) representative will contact the Plan and request the necessary information or forms to expedite the resolution of a ESRD status. beneficiary’s At the beginning of May 2015, the CMS Central Office (DMEC and DPO) instructed the RPC to place a moratorium on reviewing ESRD and ESRD Removal transactions, including any transactions received prior to the beginning of the month. The RPC was later instructed to affix the following disposition code to the held ESRD transactions once the aforementioned HPMS memo was distributed to the Plans: 110 - Pursuant to the May 22, 2015 HPMS memo, Plans are no longer required to submit supporting documentation to the RPC in an attempt to update a ESRD status in the beneficiary’s CMS systems. Please contact the MAPD Help Desk for further assistance. Per the CMS Central Office, the review of ESRD and ESRD Removal transactions is no longer part of the of work. RPC’s scope Should you have any questions regarding the discontinuation of the ESRD review RPC’s process, please contact our Client Services Department at:
Date: June 3, 2015 To: Medicare Advantage Organizations, Part D Sponsors, Medicare-Medicaid Plans, Cost-based Plans, PACE Organizations, and Regional Office Account Managers From: Thomas Siedlik Assistant Program Director, Retroactive Processing Contractor (RPC) Reed & Associates, CPAs Inc. Subject: Discontinuation of the ESRD Review Process This memorandum is being sent in addition to the “Medicare Advantage Prescription Drug System (MARx) June 2015 Payment – INFORMATION” memo posted to HPMS on May 22, 2015. Effective immediately, when trying to reconcile ESRD statuses for beneficiaries, Plans are no longer required to submit transaction requests and supporting documentation to the RPC. If Plans have concerns or questions about ESRD payments or a beneficiary’s ESRD status change/update, please contact the MAPD Help Desk to open a Remedy ticket. A Division of Payment Operations (DPO) representative will contact the Plan and request the necessary information or forms to expedite the resolution of a beneficiary’s ESRD status. At the beginning of May 2015, the CMS Central Office (DMEC and DPO) instructed the RPC to place a moratorium on reviewing ESRD and ESRD Removal transactions, including any transactions received prior to the beginning of the month. The RPC was later instructed to affix the following disposition code to the held ESRD transactions once the aforementioned HPMS memo was distributed to the Plans: 110 - Pursuant to the May 22, 2015 HPMS memo, Plans are no longer required to submit supporting documentation to the RPC in an attempt to update a beneficiary’s ESRD status in the CMS systems. Please contact the MAPD Help Desk for further assistance. Per the CMS Central Office, the review of ESRD and ESRD Removal transactions is no longer part of the RPC’s scope of work. Should you have any questions regarding the RPC’s discontinuation of the ESRD review process, please contact our Client Services Department at:
06-03-2015_Discontinuation_of_the_ESRD_Review_Process.docx