06142024 MMP Connect Direct Form

Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations (CMS-10340)

06142024 MMP Connect Direct Form

OMB: 0938-1152

Document [docx]
Download: docx | pdf


Medicare-Medicaid Plan Data Connect:Direct Form


OMB No. 0938-1152

Expires 03/31/2025




Contact Information

Contact the Customer Service Support Center (CSSC) Help Desk with any questions using the following contact information:

Phone Number: 1-877-534-2772

Email Address: [email protected]


Network Mapping Values

In order to set up network mapping entry by the submitter, the following values are provided. Palmetto GBA uses Secure Point of Entry (SPOE) to enforce data security. The CSSC Help Desk will provide the Network Address Translation (NAT) IP Address and Listener Port to the submitter during the connectivity testing phase.


Node ID

SCA.A70NDM.MC

System Platform

OS390, z/OS


Data Submission Information

Listed below are values needed by the submitter to code Connect:Direct scripts. The CSSC Help Desk will provide the Submitter ID value that will be used in the Data Set Name (DSN).


DISP = NEW,CATLG,DELETE UNIT = SYSDG

Medicare Prescription Drug Event (PDE) Data Submission Dataset



DSN

MAB.PROD.NDM.MMFS.PDE.<submitter id>(+1)

SPACE

(CYL,(1200,500),RLSE)

DCB

(RECFM=FB,LRECL=1000,BLKSIZE=32000)


Medicare Risk Adjustment Data Submission Dataset


DSN

MAB.PROD.NDM.MMFS.RAS.<submitter id>(+1)

SPACE

(CYL,(75,10),RLSE)

DCB

(RECFM=FB,LRECL=512,BLKSIZE=27648)

Medicare Encounter Data Submission Dataset


DSN

MAB.PROD.NDM.MMFS.ENC.<submitter id>(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=80,BLKSIZE=27920)


Medicaid Data Submission Dataset


DSN

MAB.PROD.NDM.MMFS.MCD.<submitter id>(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=80,BLKSIZE=27920)


Medicaid National Council for Prescription Drug Programs (NCPDP) Data Submission Dataset


DSN

MAB.PROD.NDM.MMFS.NCP.<submitter id>(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=3700,BLKSIZE=25900)

Submitter's Network Mapping Values

Provide the following network mapping values to establish bi-directional data transfers with Palmetto GBA.


NAT IP Address

(Obtain from the Network Service Vendor)


Listener Port


Node ID



System Platform

Shape3

Mainframe AS/400

Server


Additional Information

If submitting data files, the Production ID is required. If the submitter's system requires login credentials to receive data files, provide the Login ID.



Production ID


Login ID


Technical Contact Name


Phone Number


E-mail Address


Dataset Names

To receive multiple data files and prevent overwriting of existing files, it is recommended that Generational Data Group (GDG) dataset names (mainframe platform only) or dataset names containing date and timestamp (any platform) are provided.


Prescription Drug Event


Frequency = Daily

Prescription Drug Front End System (PDFS) Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



Drug Data Processing System (DDPS) Return File

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



DDPS Transaction Error Summary

Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name



Monthly reports are grouped by date of service year and will be distributed in one dataset unless datasets containing a variable for the year is provided.


Frequency = Monthly


DDPS 04 COV Cumulative Beneficiary Summary

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name




DDPS 04 ENH Cumulative Beneficiary Summary

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



DDPS 04 OTC Cumulative Beneficiary Summary

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



P2P 40 COV Accounting (YTD Cumulative P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name


P2P 40 ENH Accounting (YTD Cumulative P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



P2P 40 OTC Accounting (YTD Cumulative P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



P2P 41 COV Receivable (Monthly P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name




P2P 42 COV Part-D Payment Reconciliation (YTD Cumulative P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



P2P 43 COV Payable (Monthly P2P Activity)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



44 COV Other TrOOP Amount Indicator Summary (CY 2023 only)

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name




Frequency = Bi-Annually


DDPS Potential Exclusion Warning Report

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



Frequency = Annually



P2P Phase III Return File

Format

DSORG=PS,LRECL=1000,RECFM=FB

Dataset Name



Risk Adjustment


Frequency = Daily


FERAS Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



RAPS Return File

Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name



RAPS Transaction Error Report

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



RAPS Transaction Summary

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name




RAPS Duplicate Diagnosis Cluster

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



Frequency = Monthly



RAPS Monthly Plan Activity

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



RAPS Cumulative Plan Activity

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



RAPS Monthly Error Frequency

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



Frequency = Quarterly



RAPS Quarterly Error Frequency

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name


Medicare Encounter Data


Frequency = Daily


Invalid Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name




TA1 Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



999A Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



999R Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



277CA Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



MAO-001 Data Duplicates Report

Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name




MAO-001 Data Duplicates File

Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name



MAO-002 Data Processing Status Report

Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name



MAO-002 Data Processing Status File

Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name


Medicaid Data


Frequency = Daily


Invalid Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name




TA1 Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



999A Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



999R Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



277CA Acknowledgement Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name



Dental


Frequency = Daily


Dental Validation Report

Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name



NCPDP


Frequency = Daily



National Council for Prescription Drug Program (NCPDP) Response

Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name




According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1152. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.

Shape1 Shape2

Form CMS-10340 (03/2025)

1


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Modified0000-00-00
File Created2024-07-27

© 2024 OMB.report | Privacy Policy