Release of the Coverage Gap Discount Program 2017 Benefit Year Closeout Invoice Reports
The Centers for Medicare and Medicaid Services (CMS) is announcing the upcoming release of the Coverage Gap Discount Program (CGDP) 2017 Benefit Year Closeout Invoice Reports for manufacturers and Part D sponsors. The closeout reports contain the status of the manufacturer’s upheld disputes for the closed benefit years. The reports also indicate whether the issue that caused the invoiced Prescription Drug Event (PDE) to be disputed was resolved and if the correction resulted in financial or non-financial changes to the invoiced PDE data.
This reporting process also allows the Part D sponsor to remit payment for any gap discounts invoiced in Quarter 17 (Q17) that were successfully disputed and for any successful disputes from previous quarters of the benefit year in which the Part D sponsor has only recently corrected the PDE record(s). Manufacturers should note that successful disputes can result in a full adjustment, partial adjustment, or no adjustment to the gap discount amount.
The benefit year closeout reports are released on an annual basis. The CGDP Third Party Administrator (TPA) will release a notification to the manufacturers and Part D sponsors when the reports are distributed. The 2017 Benefit Year Closeout Invoice Reports will be released on July 14, 2022, and will include data for benefit years 2017, 2016, and 2015.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 12, 2022
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.