July 2016 Retiree Drug Subsidy (RDS) Webinar: Mainframe Submission - File Location Change

On Wednesday, July 13, the Centers for Medicare & Medicaid Services' (CMS') Retiree Drug Subsidy (RDS) Center hosted a webinar about the upcoming file location change for Vendors that submit cost and/or retiree data files to the RDS Center Mainframe using Connect:Direct. Both Vendors and associated Plan Sponsors were in attendance. CMS' RDS Center discussed the following topics:

Impact to Mainframe Submitters: What's Changing?

During this portion of the presentation, CMS' RDS Center discussed the Mainframe Submission: File Location Change resource page located on the RDS Program Website, exactly what is changing and why, the impact to Vendors, and how the current Mainframe file formats are not changing.

  • RDS Program Website Resource Page: The announcement about the file location change was published on April 22. Additionally, CMS' RDS Center published the Mainframe Submission: File Location Change resource page. Accessible from the RDS Program Website Resource Library and Quick Links, this page offers a central location for information about the change. CMS' RDS Center will be updating this page as needed throughout the transition.
  • What's Changing and Why: Currently some RDS systems process in a Mainframe environment. CMS' RDS Center is in the process of moving these RDS systems off of the Mainframe and into a server environment. Some Vendors currently send cost files and/or retiree files to CMS' RDS Center using Connect:Direct. These files currently land on the RDS Mainframe. CMS' RDS Center will no longer have access to the Mainframe once it moves to a server environment. As a result, files need to be sent to a new location to be retrieved by RDS systems. Vendors that send files using Connect:Direct will need to make a configuration change to reference the new location. No code change is needed since the file formats are remaining the same. Files uploaded through the RDS Secure Website or sent by COB:VDSA/MIR contractors are not affected.
  • Impact to Vendors: CMS' RDS Center anticipates the following changes:
    • Incoming Connection: Although Vendors' local Connect:Direct configuration for receiving files will not change, they will need to add a firewall rule for incoming traffic, as files will come from a new IP.  This is assuming that the Vendor has a firewall blocking incoming traffic. 
    • Outgoing Connection: Each Vendor's configuration for sending files must change. Vendors currently send files to the RDS Mainframe using a Mainframe IP and port. After the cutover to the new location is complete, Vendors will need to send files to a mid-tier IP and port. The NDM node name will also change. Additionally, Vendors that have a firewall blocking outgoing traffic will need to add a firewall rule to allow files to go to the new IP and port.

      The exact IP address, port, and NDM node name will be communicated to each Vendor in an encrypted email. To assist Vendors in making the configuration changes, CMS' RDS Center will work with each Vendor during the testing window to ensure files are properly transmitted and received.

      CMS' RDS Center will also announce a cutover date. Prior to the cutover date, Vendors will continue to send production files using their current configuration. From the cutover date forward, production files must be sent to the new location to be processed by the RDS systems. Eventually, once the Mainframe is decommissioned, the actual Connect:Direct transmission will fail if Vendors attempt to send a file to the Mainframe.

  • No Change to File Formats: CMS' RDS Center emphasized that there is no change to the current file formats. Vendors should continue to create files as they are created today.

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Transition Timeframe

Next, CMS' RDS Center reviewed the transition timeframe, including how CMS' RDS Center is establishing the proper Vendor contacts.

  • Establishing Contacts: In April and May, CMS' RDS Center sent emails to the Vendor contacts currently on file, as well as the Authorized Representatives and Account Managers with applications specifying impacted Vendors. In July, emails will be sent to identified Vendor contacts to confirm the contact information. Vendors may send an email to RDS@cms.hhs.gov confirming contact information ahead of time, or if the organization's technical contact has recently changed.
  • Timeline of Events: In August, CMS' RDS Center will begin sending network information to each Vendor and set up meetings and a test schedule. In September and October, Vendors can begin exchanging test files with CMS' RDS Center. CMS' RDS Center anticipates cutting over to the new environment in late November or early December and will receive production files at the new location at that time.

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RDS Center Communications

CMS' RDS Center also reviewed the various communications it will have with Vendors and associated Plan Sponsors during the transition.

  • Contact Information: It's imperative that CMS' RDS Center knows the name, phone number, and email address of each Vendor technical contact. A technical contact is a person in the Vendor organization that has the ability and permissions to make the necessary configuration changes and send test files. CMS' RDS Center technical staff will work with these people to set up meetings and develop a test schedule to verify the connection.
  • August Communications: In August, Vendors will receive network information including the IP Address, port, and NDM node in an email with an encrypted password protected zip file attachment. Vendors should ensure they have WinZip installed in order to unzip the file. CMS; RDS Center will communicate the password to the technical contact by phone. Once Vendors have received this information, they can test that the Connect:Direct endpoint can be reached prior to sending a test file.
  • September/October Communications: CMS' RDS Center will be working with Vendors to establish a test schedule. In September and October, CMS' RDS Center will test the file exchange with each Vendor. Each Vendor will send in one or more test files. RDS will respond back with a test file and will send an email confirming the successful completion of testing. Production files must continue to be sent to the current location until the cutover date.
  • November Communications: In November, or earlier, Vendors will be notified of the exact cutover date. CMS' RDS Center will communicate this date at least 30 days in advance of the cutover. Cutover is anticipated in late November or early December after the high volume application season and before the high volume Reconciliation season. From the cutover date, files must be sent to the new location. CMS' RDS Center asks that Vendors monitor their files once the cutover is complete to ensure the files were successfully processed by RDS and response files are received.

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How You Can Prepare

CMS' RDS Center provided some tips on how Vendors and Plan Sponsors can prepare for the upcoming change.

  • Vendors: Vendors can prepare their organizations by ensuring WinZip is installed to unzip the file containing network information, verifying technical contact information, and exchanging test files with RDS when needed. Vendors are encouraged to keep their Plan Sponsors informed and watch for any deadlines in the November/December timeframe that could be impacted.
  • Plan Sponsors: Plan Sponsors can prepare by knowing which application(s) could be affected.  Did the Plan Sponsor select a Vendor to send retiree files to the RDS Center Mainframe when setting up the application? Has the Plan Sponsor chosen a Vendor to submit cost reports to the RDS Center Mainframe in Payment Setup? If so, the application is impacted by this change. Plan Sponsors are also encouraged to maintain communication with their Vendor and remain aware of files that should be sent and received in the November/December timeframe.
  • Everyone: Both Vendors and Plan Sponsors should monitor Mainframe Submission: File Location Change page on the RDS Program Website for updates. CMS' RDS Center will notify the impacted Vendors and Plan Sponsors when the page is updated.

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Questions and Answers

CMS' RDS Center discussed the following questions and answers:

How will I know if my Vendor has successfully cutover?

CMS' RDS Center will send an email to Vendor contacts and associated Plan Sponsor Account Managers and Authorized Representatives when the new connection has been successfully tested. Plan Sponsors should monitor cost and retiree file submissions and responses after the cutover to ensure files are received by CMS' RDS Center and Retiree Response Files are received.

How should I monitor cost files after the cutover?

The easiest way to monitor cost files is to subscribe to Quick Access Reports (QAR). These reports provide one stop shopping for cost reports. Both Vendors and Plan Sponsors can subscribe to this service. For more information about QAR, refer to the QAR section of the RDS User Guide for information on user roles and QAR, QAR setup, and more. Also, Vendors submitting files using Connect:Direct should set up someone from the organization as a Vendor Composite Report Recipient. This will allow the Vendor organization to view consolidated cost reporting information in QAR. If different individuals in the Vendor organization manage different applications, then the Vendor should ask its Plan Sponsors to assign individuals as Vendor Designee Cost Reporters in Payment Setup on the applications. For Account Managers and Authorized Representatives, QAR will report all cost reporting activity on all applications.

The other way to monitor cost reports is to view the Benefit Option cost list for each individual application. If managing several applications, QAR is a better approach.

Will we continue to receive response files and how?

Yes, Retiree Response Files and Weekly Notification Files will continue to be sent using the Electronic Data Interchange (EDI) method established in Step 7 of the application.

Will there be RDS application changes for the EDI method?

The EDI method selection for applications will not change. However, Plan Sponsors may wish to modify the EDI method in Step 7 of the application to receive copies in the RDS Secure Website.

How should I monitor retiree processing after the cutover?

There are several ways to monitor retiree files depending upon the type of file:

  • For new applications, Plan Sponsors may look at the received status and received date for the Valid Initial Retiree List on the Application Status page.
  • For previously approved applications, Retiree Response Files can be monitored through several ways:
    • Retiree Response Files are always sent back to the Vendor that sent the retiree file using Connect:Direct.
    • There are two conditions for viewing retiree files on the RDS Secure Website: 1) the user must be an Account Manager, Authorized Representative, or Designee with View/Send/Receive Retiree Data privilege; 2) the Retiree Response File will only be available for download on the RDS Secure Website if the Plan Sponsor elected to send a copy to the RDS Secure Website when selecting EDI methods on the Application Status page. If the Plan Sponsor did not select this option originally, it can go back and change it in application Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources. The retiree list response method can be changed from “Vendor Mainframe to RDS Center Mainframe” to “Vendor Mainframe to RDS Center Mainframe with a copy of all Retiree Response Files sent to the RDS Secure Website”. The method for sending Weekly Notification Files may also be changed there.  
    • Account Managers, Authorized Representatives, and Designees with the View/Send/Receive Retiree Data privilege should receive an email whenever a Retiree Response File or Weekly Notification File is created.
    • Another way to determine if a Retiree Response File has been created is to look at the response file date under Current Covered Retiree Counts. Again, only Account Managers, Authorized Representatives, and Designees with the View/Send/Receive Retiree Data privilege can see this information on the RDS Secure Website. Vendors wishing to see retiree information on the RDS Secure Website must be assigned to the application with the View/Send/Receive Retiree Data privilege.  
  • For Weekly Notification Files:
    • Plan Sponsors may check the Weekly Notification File delivery method in Step 7 of the application. For notifications, Plan Sponsors can choose to send the file to the Vendor that last sent in the retiree file, the RDS Secure Website, or both.
    • For at least 90 days after the cutover, Plan Sponsors may want to send notifications to both the Vendor and the RDS Secure Website to ensure notifications are received.
    • The last date a Weekly Notification File was created is also displayed under Current Covered Retiree Counts in the Manage Retirees section of the application.

How long will it take to process my files with the new system?

CMS' RDS Center expects to process incoming retiree files and create Retiree Response Files in the server environment in about the same timeframe as files are currently processed, as CMS' RDS Center is dependent on other systems such as the Medicare Beneficiary Database (MBD). However, CMS' RDS Center anticipates some improvements, such as creating the Covered Retiree List closer to real time instead of waiting for an overnight batch cycle.

Is there a specific point of contact at CMS' RDS Center?

Any questions regarding this change should be emailed to RDS@cms.hhs.gov or submitted in an RDS Secure Website support request. CMS' RDS Center will engage the appropriate parties to respond to inquiries.

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Overpayment Remittance Reminders

Finally, CMS' RDS Center provided a reminder to Plan Sponsors about sending overpayment remittances. Attendees were reminded that the address for sending an overpayment remittance changed on April 1, 2016. All payments and any RDS mail should be sent to the new address. Plan Sponsors working with a third party that sends correspondence to RDS should inform those parties and the individuals mailing the correspondence of the new address. Additionally, RDS does not complete purchase orders. Plan Sponsors should not delay in remitting payment if waiting for a purchase order, as CMS' RDS Center does not complete them.

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