Red Lined _ MMP Connect Direct Form

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	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.

Form CMS-10340 (03/2025)

1