New 2025 Prescription Drug Event (PDE) FINAL File Layouts - FIELD UPDATES

CMS published an HPMS memo on October 31, 2023, entitled “New 2025 Prescription Drug Event (PDE) FINAL File Layouts - FIELD UPDATES”, that included two attachments, the “PDE-Inbound-File-Layout-Final-20250101_Q4-2023” and the “PDE-Outbound-File-Layout-Final-20250101_Q4-2023”. The purpose of this memo is to share field updates to the new 2025 Prescription Drug Event (PDE) Final File Layouts, which will become effective on January 1, 2025, previously published on April 18, 2023 as attachments to the HPMS memo entitled “New 2025 Prescription Drug Event (PDE) File Layouts (FINAL)”. In the April 18, 2023 memo, it was noted that CMS would be issuing separate guidance regarding the operational implementation of the Inflation Reduction Act (IRA), which may include additional PDE File Layout updates. The October 31, 2023 HPMS memo describes these updates, which include one (1) new PDE field that is being added, one (1) PDE field that is being updated, and three (3) PDE fields that will be removed in the attached updated 2025 PDE Final File Layouts_Q4-2023. CMS strongly recommends that plans please review this memo and its attachments carefully, and share with your information technology staff for their reference in the future implementation of these changes.

As a reminder, beginning January 1, 2025, new PDE file layouts will become effective, and Part D sponsors must use the new 2025 PDE Inbound File Layout to submit PDE records for all Benefit Years and all Dates of Service (DOS), including Benefit Years prior to 2025 and DOS prior to January 1, 2025. PDE response files sent from CMS to Part D sponsors will also follow the new 2025 PDE Outbound File Layout, beginning January 1, 2025. Additional information regarding the new PDE file layouts can be found in the April 18, 2023, HPMS memo, “New 2025 Prescription Drug Event (PDE) File Layouts (FINAL)”. The existing PDE Inbound File Layout, published on the CSSC Operations website under File and Report Layouts, will be accepted prior to the effective date of the 2025 PDE Inbound File Layouts on January 1, 2025.

In the event you have questions, please contact CSSC Operations at 1-877-534-2772 (option 2) or by email at csscoperations@palmettogba.com.