As summer comes to an end, insurers need to think seriously about December. The first estimate calculations from CMS will come in the middle of December, but only for those who register in September or early October and quickly begin setting up their servers and testing data submissions.
Fortunately, CMS’s recent release of its EDGE server implementation timeline means we can clearly see all the tasks involved and the deadlines to hit.
- Preregistration: now through September 26
- Select Amazon or the on-premise EDGE-server option.Register for HIOS account IDs.
- Review CMS training materials and operational manuals on pre-implementation and implementation activities.
- Register for access to the EDGE server registration site.
- Set up an AWS account, if using (including BAA, which can take up to four weeks).
- Registration: September 27 through October 20
- CMS will open the registration site on September 27.
- CMS will monitor registration and provide technical assistance to issuers.All EDGE-server requests must be submitted by October 17.
- CMS’s review and approval will be complete by October 20.
- Provisioning: September 27 through November 21
- CMS will begin monitoring provisioning data and providing technical assistance on September 27.
- The provisioning process must be complete by November 21.
- Provisioning will be automated for Amazon EDGE servers, but on-premise servers must complete a manual provisioning process.
- Data collection: September 27 through April 30
- CMS will begin providing technical assistance to issuers that need file processing support and reaching out to issuers with data submission issues on September 27.
- Issuers must have completed the process of testing their data in the EDGE test zone by December 5.
- Issuers must submit final 2014 data by April 30.
- First production file must be submitted by December 5 to be included in the first payment estimate calculations.
- After December 5, issuers must make sure they are resolving data errors and updating their data.
- First risk-adjustment and reinsurance calculation estimates: December 15 through March 31
- Mid-December: CMS runs first RA and RI estimate reports.
- Mid-December: CMS will review estimate reports and provide TA to issuers with deficiencies.
- Mid-December: Issuers review RA and RI estimate reports and provide CMS with feedback.
- Payment calculations: May 1 through June 30
- Issuers should review final estimate report and provide feedback to CMS.
- Issuers should provide 2014 coverage-year payment report for RA and RI by June 30.
- Payment report to issuers: June 30
- Issuers should review the payment report and provide feedback to CMS.
CMS will provide technical details and operational guidance in a series of webinars and user groups over the next few months. Webinars will be held Thursdays from 3:30 p.m. to 5:00 p.m. Eastern Time; user groups will be Tuesdays from 11:30 a.m. to 12:30 p.m. Eastern Time. The webinar schedule and additional resources, including slide decks on setup and security, are available in the REGTAP Library.
So, enjoy the last of the summer weather, but keep the fast-approaching fall deadlines in mind. CMS warns that issuers “must be ready to start the registration process on September 27, 2014, in order to have sufficient time to set up their servers and test their data submissions prior to the mid-December estimate calculations.”