Medicare Part D Coverage Gap Discount Program (CGDP)

This contract defines the requirements for a Third Party Administrator (TPA), acting on behalf of the Centers for Medicare and Medicaid Services (CMS), for pharmaceutical manufacturer invoicing activities. Medicare programs that require pharmaceutical manufacturer invoicing include:

the Coverage Gap Discount Program (CGDP), the Manufacturer Discount Program (MDP), the Inflationary Rebate program, and the Discarded Drug Refund Program. We refer to these programs collectively as “Medicare Drug Manufacturer Invoicing Activities” or “MDMIA.”. The TPA functions required under this contract include development, testing, implementation, operation, maintenance, and customer service necessary to meet the needs of CMS, pharmaceutical manufacturers, Part D sponsors, and contracted CMS personnel involved with the operation and administration of the MDMIA, in accordance with the provisions of the legislation listed below.