Any Part D sponsor wishing to receive Medicare Coverage Gap Discount Program (CGDP) payments from manufacturers in a banking account other than what is listed in the existing EFT file, must complete the online Electronic Funds Transfer (EFT) Information for Manufacturer Payment Form.
Sponsors new to the program in 2014, please note that your APPS banking account information was copied as your initial EFT file entry.
The completed form should be submitted online, and a printed copy provided to the TPA by express mail to ensure it is received by the deadline,
January 10, 2014. The hard copy must be signed by the organization’s Chief Financial Officer (CFO), or an individual designated to act in the CFO’s behalf. To access the online EFT Information Form go to
www.tpadministrator.com, click on the EFT Information link, then choose EFT Online Form (For Sponsor Use Only). An electronic version of the form will be saved automatically and a PDF form will be generated to print, sign and return by mail to the TPA. At the same time an electronic version will be sent to the TPA. This guidance does not apply to Part D Sponsors unaffected by the CGDP, specifically PACE Organizations and Dual Eligible Special Needs Plans.
Please direct questions to the TPA Operations either by Email at
tpaoperations@tpadministrator.com, or by telephone at 1-877-534-2772, Option 1. Please mail hardcopy documentation to one of the following addresses:
Regular Mail
Palmetto GBA TPA Support Center
P.O. Box 100275, AG-507
Columbia, SC 29202-3275
Express Mail
Palmetto GBA TPA Support Center, AG-507
2300 Springdale Drive, Bldg. One
Camden, SC 29020