Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
F.13 Risk Adjustment System (RAS) Prescription Drug Hierarchical Condition
Category (RxHCC) Model Output Data File - aka Part D RA Model Output Data
File
The following records are included in this file:
Header Record
Detail/Beneficiary Record Format
Trailer Record
F.13.1 Header Record
The Contract Header Record signals the beginning of the detail/Beneficiary records for a
Medicare Advantage or stand-alone PDP contract.
Item Field Size Position Comment Description
1
2
Record Type
Code
Contract
Number
1 1 Set to "1"
5 2-6
3 Run Date 8 7-14
4
Payment Year
and Month
6 15-20
Also known as
MCO plan
number
Format as
yyyymmdd
Format as
yyyymm
5 Filler 148 21-168 Spaces Filler
Total Length = 168
1 = Header
2 = Details
3 = Trailer
Unique identification for a Managed Care
Organization (MCO) enabling the MCO to provide
coverage to eligible beneficiaries.
The run date when this file was created.
This identifies the risk adjustment payment year and
month for the model run.
F.13.2 Detail/Beneficiary Record
Each Detail/Beneficiary Record contains information for an HCC beneficiary in a Medicare
Prescription Drug contract/plan, as of the last RAS model run for the current calendar/payment
year.
December 28, 2012 F-71 RAS RxHCC Model Output
Data File