Prepare CGDP Information for Q4 2023 Invoice Report Distribution


 

It's Time to Prepare. The Q4 2023 Medicare Coverage Gap Discount Program (CGDP) invoicing period is approaching.

 

 Update Bank Account Information

The Third-Party Administrator (TPA) will perform bank account validations on Wednesday, January 10, 2024.

Please verify that the TPA has the correct bank account information on file for both sending and receiving payments. Also, please confirm debit blocks and velocity filters on your Coverage Gap Discount Program (CGDP) accounts are updated to allow processing of your invoice payments. The Q4 2023 quarterly invoices will be distributed on Wednesday, January 31, 2024.

Failure to provide the proper bank account information prevents your company from being able to make and/or receive payments and may result in a compliance action. The Centers for Medicare & Medicaid Services (CMS) shall assess a Civil Money Penalty (CMP) on a manufacturer that fails to pay the amounts invoiced by the payment deadline of Sunday, March 10, 2024.

Pre-Note Bank Account Validation

The TPA conducts account validation every reporting period on payee and payer bank accounts and as required when participants make bank account changes.

The validation process will be conducted in the form of a pre-notification (pre-note). A pre-note is a zero-dollar test transmitted through the Automatic Clearing House (ACH) network to validate bank account information on file with the TPA.

 eSignature

The TPA utilizes electronic signature (eSignature) for all bank account change forms. To enhance security, only the associate with credentials to access the CGDP Portal (TPA Liaison or the CGDP Payment Contact) will have authorization to submit any bank account related changes. The form is accessible via the TPA website; however, the user will be taken directly to the CGDP Portal's login page.

If there is a need to update bank information, please follow these steps:

  1. Go to the TPA website: www.tpadministrator.com;
  2. Choose the "EFT Information" link;
  3. Choose "Payee/Payer Bank Account Change Form";
  4. Enter the CGDP Portal credentials on the CGDP Portal Login page;
  5. Select the "My Profile" link in the upper right corner and select either:
  • "Request Payer Account Modification" (account for sending payments);
  • "Request Payee Account Modification" (account for receiving payments);
  1. Fill out the form and follow the online instructions.

Once the authorized signer is specified, that individual will receive an email message, inviting them to review and electronically sign the account modification form. After completing the application, the signer will be prompted to enter a password, provided electronically by the TPA. After the authorized party enters their TPA-provided password, the signed form is electronically sent to the TPA for review and execution of the change. Once completed, the banking information will be updated. Executed copies of the form are emailed to both the form submitter as well as the authorized signer.

 Change of Primary Point of Contact

If a change in personnel has occurred and a new person will be interacting with the TPA, the Health Plan Management System (HPMS) must be updated to reflect this point of contact change. Contact the TPA for further instructions regarding access for the new personnel.

Pharmaceutical Drug Manufacturers and Part D Sponsors are required to periodically review their HPMS contact information for accuracy and update it as needed, as part of the CGDP requirements. HPMS contact information is a vital resource used by CMS and the TPA to disseminate important CGDP related information to program participants.

The TPA utilizes HPMS to verify contact information and to update corresponding information on CGDP accounts. Pharmaceutical Drug Manufacturers and Part D Sponsors must ensure the data displayed in HPMS is accurate and reflects the most current information for the following fields:

  • HPMS field “TPA Liaison”
  • HPMS field “Coverage Gap Discount Program (CGDP) Payment Contact”

 The HPMS information is applied to the contact information in the CGDP Portal.

  • TPA Primary Contact role = HPMS “TPA Liaison”
  • TPA Payment Initiator role = HPMS “Coverage Gap Discount Program (CGDP) Payment Contact”

Select the HPMS link below to sign in and update contact information on HPMS.

 HPMS logo

 

If you have any questions, please contact the TPA by phone at 1-877-534-2772, option 1 or by email at tpaoperations@tpadministrator.com.


Last Updated: 01/03/2024