Updates to CGDP Quarterly Invoice Manufacturer Data and Invoice Report File Layouts

The Centers for Medicare and Medicaid Services (CMS) is announcing file layout changes in the Coverage Gap Discount Program (CGDP) quarterly invoice Manufacturer Data and Invoice reports. Field length changes are necessary on the TPALT (Labeler Trailer) and LBLR (Manufacturers Total at the Labeler Level) record types. The following Gap Amount field lengths will be in order to support data sizes greater than the current allowable Gap amount fields.

The following fields are:

• TOTAL REPORTED GAP DISCOUNT PREVIOUS AMOUNT  
  • Field size will increase from S9(9)v99 to S9(12)v99
• TOTAL REPORTED GAP DISCOUNT CURRENT AMOUNT  
  • Field size will increase from S9(9)v99 to S9(12)v99
• TOTAL GAP DISCOUNT AMOUNT THIS PERIOD    
  • Field size will increase from S9(9)v99 to S9(12)v99

Links to the new file layouts have been added to the TPA Website under the ‘Invoices’ topic and ‘Manufacturer Quarterly Invoice Report Layouts’ at TPA - Manufacturer Quarterly Invoice Report Layouts (tpadministrator.com).

Changes to the TPALT and LBLR record types are planned to be implemented on August 31, 2022 for the Q2 2022 invoice reports distribution to give your company adequate time in the event they need make internal programming changes to accommodate the increased character lengths of the fields.

If you have any questions, please contact the TPA at tpaoperations@tpadministrator.com.

Select the link above to access HPMS.

Review the HPMS memo titled 'Updates to CGDP Quarterly Invoice Manufacturer Data and Invoice Reports File Layouts' dated March 25, 2022.