• Electronic Data Interchange (EDI)
Approved Network Service Vendors Submitter Authorization Form
• Front-End Systems User Guides
Front-End Systems User Guides
• Medicare Encounter Data
Companion Guides ED Testing Edits EDPS Bulletins Enroll to Submit Encounter Data HPMS Memos ListServ Newsletters PC ACE Pro32 Report and File Layouts Resources Training Information User Group
• Medicare Medicaid Plans
Companion Guides Edits Enroll to Submit Medicare-Medicaid Data FAQs HPMS Memos ListServ Medicare-Medicaid Testing References Report Layouts State Agency Information Training
• Prescription Drug Event
Coverage Gap Discount Program Drug Data Processing System (DDPS) Edits Enroll to Submit PDE File Layouts Frequently Asked Questions ListServ National Drug Code (NDC) Payment Reconciliation Summary Reports (PRS) Prescription Drug Front-End System (PDFS) References Report Layouts Social Security Number Removal Initiative (SSNRI) Updates Training User Group
• Risk Adjustment Processing System
Edits Enroll to Submit Risk Adjustment Data Front-End Risk Adjustment System (FERAS) HPMS Memos Job Aids ListServ Newsletters RAPS Bulletins References Risk Adjustment Processing System (RAPS) Training User Group

An updated version of the 2013 PDE Reporting and Calculation Guidance is posted to the CSSC website. CMS has updated the rounding rounds for PDE reporting to add more clarification to the section. In example #11, the second table was updated with the correct Ingredient Cost Paid, GDCB, and GDCA. Step 4 of example #20 was re-worded to clarify that when a low income beneficiary is in the coverage gap phase, the LICS amount is determined by taking the total cost of the drug in the coverage gap and subtracting out the LICS co-pay amount. Example 21, step 4, has been changed to demonstrate that when an MSP claim falls within the Coverage Gap Phase the beneficiary pays 97.5% of the drug cost and the plan pays 2.5% of the drug cost as CPP in benefit year 2013. The language in Scenario 1 in the PDE editing section has been updated to be consistent with the language released in the December 26, 2012 HPMS memo describing the editing logic for edit code 870. Any questions about the updates can be sent to PDEJan2011@cms.hhs.gov.