How RDS Recovery Works

RDS Analytics manages Retiree Drug Subsidy programs for plan sponsors including self-insured employers, unions, and municipalities. We work within the Centers for Medicare and Medicaid Services (CMS) Retiree Drug Subsidy (RDS) Service Center framework on your behalf, from filing to recovery. Plan sponsors don't lose subsidy dollars because they are reconciling their RDS payment submission on third party data sets. Plan sponsors are not receiving optimal RDS payments because their claims and eligibility data runs through three separate systems (TPA eligibility files, PBM claims and rebate data, and CMS's own reason codes), and the challenge is to reconcile all three data sources before the deadline closes. By having RDS Analytics conduct a free evaluation of your plans current Retiree Drug Subsidy (RDS) submission framework, we will provide a no direct cost analysis that will determine if you have any past or current financial loss of subsidy under the Retiree Drug Subsidy program. We will determine where the financial loss is occuring and how to stop the leakage. The vast amount of leakage occurs during critical CMS Reconciliation phases, where legacy processing capabilities lack the advanced algorithms necessary to optimize the Finalize Covered Retirees step, leaving complex member eligibility mismatches and qualifying drug cost discrepancies unresolved before data freezing. Because Plan Sponsors face a strict 15-month CMS Reconciliation Deadline from the Plan Year End Date—after which unsubmitted subsidies are permanently forfeited—relying on the legacy platform introduces severe compliance and financial risks. Transitioning to the RDS Analytics Rx Intelligence Tech Stac SM ensures full alignment with Centers for Medicare & Medicaid Services (CMS) optimization guidelines, establishing the requisite administrative precision during the Manage Final Costs phase to halt financial leakage, correct legacy vendor-driven performance deficits, and secure maximum program compliance. That's the gap we fill, and it's only closable now that cross-referencing census, claims, and CMS data at scale through our Superior Intelligence capabilities that make this seismic shift in data iterations actually possible. We're not a general benefits consultant with RDS as a side offering. It's the only thing we do.