News

Front End Systems Award to Palmetto GBA

Palmetto GBA Wins a CMS contract for Front End System (FES) Support for Collection and Processing of Part C Encounter Data, Part C and Part D Risk Adjustment Processing System (RAPS) Data, Part D Prescription Drug Event (PDE) Data, and Medicare Medicaid Plan (MMP) Encounter Data.

The purpose of this contract is to procure FES support and services for ingesting and processing data records for four component front-end IT systems. The four FES component systems are:

  1. Encounter Data System Front End System (EDFES)
  2. Risk Adjustment Processing System (RAPS)
  3. Prescription Drug Front End System (PDFS)
  4. Medicare Medicaid Plans (MMPs) Front End System

The FES takes in and processes all Medicare Part C and Part D program data records 24 hours a day, 7 days a week.  As the FES contractor Palmetto GBA is responsible for the design, development, testing, implementation, operation, and maintenance of these four front end systems.  The core FES functions pertain to managing a large, multi-component IT system.  The customer support function is a relatively small part of the FES contract, and focuses on assisting external entities to solve problems they have in interfacing with the FES.

The FES also is responsible for feeding accurate and timely data to downstream systems that generate payments for the Medicare Advantage Part C program, the Part D program, and the Medicare-Medicaid plan demonstration program, as well as to a downstream data warehouse that is the data source for demonstration evaluators.  Currently, Part C and D program payments are about $250 billion a year for items and services provided to about 18 million Part C beneficiaries receiving medical services through Medicare Advantage (MA) plans and about 40 million Fee-for- Service and Part C beneficiaries receiving prescription drugs through Part D plans.