The Medicare Prescription Drug Improvement and Modernization Act of 2003 (Medicare Modernization Act or
MMA) established the Medicare Part D prescription drug benefit effective January 2006. At that time, Medicare
became the primary payer for most prescription drugs for full-benefit dually eligible beneficiaries. However,
the MMA established the phased-down state contribution process, in which states are responsible for making
monthly payments to CMS, representing a portion of the expenditures for beneficiaries whose Medicaid drug coverage has been assumed by Medicare Part D.
The 2021 version of the State Phased-Down (SPD) Billing Guide (PDF) updates information and instructions for states on operations concerning the state phased-down contribution process, including:
- Relationship between state reporting and the SPD contribution amount
- SPD Contribution Billing
- State Itemized Liability Report
- Offset Against State Medicaid Grant Award
- Methods States May Use to Pay the SPD Contribution Amount
- Fedwire Procedures
- Pay.gov
Send an email to DPBCStateBuy-in@cms.hhs.gov for SPD contribution billing inquiries and requests.
Phased-Down State Contribution Per Capita Rates
State Medicaid Director Letter on CY 2022 Jan-Sep Claw Back Phased-Down State Contribution Amounts
State Medicaid Director Letter on CY 2021 Oct-Dec Claw Back Phased-Down State Contribution Amounts