Part D Information for Pharmaceutical Manufacturers
This page provides important information related to Part D program for Pharmaceutical companies.
The Medicare Coverage Gap Discount Program (Discount Program) makes manufacturer discounts available to eligible Medicare beneficiaries receiving applicable, covered Part D drugs, while in the coverage gap. In order to participate in the Discount Program, manufacturers must sign an agreement with CMS to provide the discount on all of its applicable drugs (i.e. prescription drugs approved or licensed under new drug applications or biologic license applications). Beginning in 2011, only those applicable drugs that are covered under a signed manufacturer agreement with CMS can be covered under Part D.
CMS has provided on the download section of this page information about the Discount Program contracting process, the list of participating manufacturers, Labeler Codes and associated Labeler Codes Firm Names.
Please click the selection that best matches your area of interest and check back, as we will continue to update these resources regularly.
- Medicare-Coverage-Gap-Discount-Program-January-2019-Labeler-Code-File [ZIP, 364KB]
- Request-For-P-Number-2020 [PDF, 46KB]
- Manufacturer Coverage Gap Discount Guidance (v.052017) [ZIP, 436KB]
- Coverage Gap Discount Program - Timely Payment Determination [PDF, 128KB]
- CY 2018 Medicare Contract Plan BIN PCN File (May, 2017) [XLSX, 236KB]
- CY 2017 Medicare Contract Plan BIN PCN File (March 2017) [ZIP, 26KB]
- CY 2016 Medicare Contract-Plan BIN.PCN File (v.2.18.2016) [XLS, 599KB]
- Medicare Coverage Gap Discount Program - Labeler Code Update Calendar (v032018) [ [PDF, 76KB]
- Medicare Coverage Gap Discount Program- Program Invoicing Dates [PDF, 583KB]
- CY 2015 Medicare Contract Plan BIN PCN File [XLS, 592KB]
- Manufacturer Appeal Decision Letters [ZIP, 3MB]
- Medicare Coverage Gap Discount Program - Dispute Resolution [PDF, 123KB]
- Medicare Coverage Gap Discount Program - Maximum Discount [ZIP, 206KB]
- Medicare Coverage Gap Discount Program - Part D Sponsor Program Guidance (5/21/10) [ZIP, 606KB]
- Medicare Coverage Gap Discount Program-Manufacturer's Agreement (05.2018) [PDF, 79KB]
- Medicare Coverage Gap Discount Program Third Party Administrators Agreement (v042017) [PDF, 48KB]
- Page last Modified: 12/27/2018 12:49 PM
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