EFT Form Update Reminder

This is a general reminder that the Q3 2015 Coverage Gap Discount Program (CGDP) invoicing period begins on October 31, 2015. Please make sure that the TPA has the correct bank account information on file for both sending and receiving payments. Failure to provide the correct banking information prevents your company from being able to make and/or receive payments and may result in a compliance action if payments cannot be made in time.

 

Pharmaceutical Manufacturers or Part D Sponsors wishing to change their CGDP banking information in advance of the October 31, 2015, quarterly invoice distribution date must fill out the EFT Online Form as soon as possible. The EFT Online Form is located on our website, www.tpadministrator.com. Click on “EFT Information” in the menu on the left side of the page and then choose the “EFT Online Form (For Manufacturer Use Only)” or “EFT Online Form (For Sponsor Use Only)” from the list. Complete the form online and click the submit button. An electronic version will automatically be sent to the TPA and a PDF form will be generated for you to print, sign (must be signed by the organization’s Chief Financial Officer (CFO) or an individual designated to act on the CFO’s behalf), and return by express mail to the TPA. Please ensure that your mailed form is received at the TPA by October 28, 2015.

 

The form for changing the account to be debited or for making payments is located on our website, www.tpadministrator.com. Click on “EFT Information” in the menu on the left side of the page and then choose the “ACH Payment Information Change Request Form (Account to be debited for payments made).” The form is available to be filled out electronically, but once completed the form must be printed, signed (must be signed by the organization’s CFO or an individual designated to act on the CFO’s behalf), and express mailed to ensure it is received at the TPA by October 28, 2015.

 

Signed, hardcopy forms must be sent to one of the following addresses:

Express Mail (Preferred)

Palmetto GBA TPA Support Center, AG-507

2300 Springdale Drive, Bldg. One

Camden, SC  29020

 

Regular Mail

Palmetto GBA TPA Support Center

PO Box 100275, AG-507

Columbia, SC  29202-3275

 

Please direct questions to TPA Operations either by email at tpaoperations@tpadministrator.com or call us at 877-534-2772, Option 1.