Don't leave government Retiree Drug Subsidy dollars on the table. Recover what's owed.
RDS Analytics™ is unique in its capabilities to deliver high-performance Retiree Drug Subsidy recovery services that produce and recover more Federal subsidy dollars that ultimately reduce your annual retiree drug plan costs.
For most Municipal and State Governments, Taft Hartly Plans (Unions) and Enterprise employers, much of the subsidy that RDS Analytics™ recovers is from unclaimed funds that hide in the drug claim data that create data gaps that are too hard to catch across large, complex Pharmacy Benefit Manager (PBM) claims files. Coupled with eligibility files that have difficulty cross-walking within the complexities of the Centers for Medicare and Medicaid Services (CMS) mainframe, plan sponsors frequently suffer subsidy suppression in excess of 15% or more.
Ultimately, between Medicare Part D transitions and drug claim data systems that don't talk to each other, it's easy for RDS subsidies to leak through the cracks, and most plan sponsors have no way to effectively stop the leakage from porous PBM drug claims data. RDS Analytics Rx Intelligence Tech Stac SM identifies those missed dollars, and our data analysts have the specialized data analytics capabilities to drive multiple iterations that recover the subsidy dollars you are owed. Simultaneously, you need to know if the RDS program is still the right choice for your Retiree Drug benefit program. Unique to the RDS Analytics Rx Intelligence Tech Stac SM our analysts will compare a plan sponsors RDS subsidy payment after the additional RDS funding is recovered against an Employer Group Waiver Plan (EGWP) and determine which option is better for your bottom line.
RDS ROI Calculator
Enter your most recently Reconciled plan year Retiree Drug Subsidy payment and the eligible lives from the same plan year Covered Retiree List (CRL)
Review your filingServices
RDS audit and recovery, full program administration, and EGWP vs. RDS strategic advisory. See what's included on our Services >.
How RDS Audits Work
An RDS audit uncovers missed Retiree Drug Subsidy dollars in your claims data and recovers them. See how it works, from free audit to final report: How RDS Audits Work >. The unique aspects of the RDS Analytics Rx Intelligence Tech Stac SM to deliver differential efficiency through our Rx Intelligence Tech Stack Trade Off Analysis SM ensure you are fully optimizing the benefits of the Federal drug subsidy programs by delivering RDS to EGWP transition consulting and Actuarial Equivalence Testing.
Frequently Asked Questions
What's the difference between EGWP and RDS?
RDS reimburses your plan for 28% of allowable retiree drug costs between the CMS cost threshold and cost limit, and your plan keeps the risk and the annual filing. An EGWP is a Medicare Part D plan run by a private carrier: the carrier takes on the risk and administration in exchange for a subsidy of its own, and charges your plan a fixed cost per member. Which one costs less depends on your actual per-member drug spend, not on which one you've always used.
What's the RDS cost threshold and cost limit?
CMS sets a floor (the cost threshold) and a ceiling (the cost limit) on per-retiree drug costs eligible for the subsidy. Costs outside that range don't count toward your reimbursement, so tracking both matters as much as tracking total spend.
How do I complete RDS reconciliation?
You submit final cost data through the CMS RDS Secure Website within 15 months of the plan year's end, net of manufacturer rebates, matched against your Covered Retiree List. Most sponsors bring us in here specifically because the data cleanup takes longer than the filing itself.
What happens if we miss the deadline?
You may lose that plan year's subsidy. Contact the CMS RDS Center promptly to review any available options.
Can we recover subsidy from a closed year?
Prior-year recovery may be possible when CMS permits reopening or correction. Eligibility depends on the plan year, filing status, and supporting data.
What counts as creditable coverage under Medicare Part D?
Coverage that pays, on average, at least as much as standard Medicare Part D. RDS requires your plan to meet this bar every year, which is what “actuarial equivalence” is actually measuring.
Why would I choose an EGWP over RDS?
An EGWP makes sense when your actual per-member drug spend is high enough that a private carrier's fixed cost, backed by its own federal subsidy, comes in lower than what RDS nets you after keeping the risk and the filing burden yourself. It doesn't make sense for every plan. Our Rx Intelligence Platform weighs your real numbers to tell you which side of that line you're on.
Why is RDS recovery more effective now than in the past?
Reconciling census records, PBM claims, and CMS's own reason codes for every retiree used to be too labor-intensive to do completely by hand, so gaps went unnoticed. Our Rx Intelligence Platform now runs that full match automatically, which is why more of the subsidy is recoverable today than it was even a few years ago.
Not sure how much you're leaving on the table?
Recovery windows can close. Questions? Talk to our team, or review your latest RDS filing.