MDP Reconciliation

The Centers for Medicare & Medicaid Services (CMS) completes the calculations for the Part D Manufacturer Discount Program (MDP) Reconciliation, which are performed in accordance with section 1860D-14C of the Social Security Act, 42 C.F.R. § 423.2744, and associated guidance. The MDP Reconciliation utilizes a set of management reports from the Payment Reconciliation System (PRS). The PRS reports specify the inputs and results of a specific payment reconciliation.

These reports contain sensitive financial information and provide data on Part D MDP payment adjustments used by CMS to remit and recover these calculated MDP reconciliation amounts for Part D Plan Sponsors.

There are two (2) file layouts that assist Part D Plan Sponsors with understanding the format of the information provided in the MDP Reconciliation reports loaded to and made available for download in the MDP PRS portal. These management reports detail the inputs and results of the MDP reconciliation process for the specified coverage year.

The MDP Reconciliation Inputs Report provides plans with beneficiary-level inputs received from the Medicare Advantage and Prescription Drug System (MARx) and the Drug Data Processing System (DDPS). This report displays the total dollar amount of Part D prospective MDP payment and the total dollar amount of the Part D invoiced MDP payment for the coverage year for each beneficiary enrolled in the plan. The MDP Reconciliation Inputs Report allows plans to validate the beneficiary-level inputs received from DDPS and MARx that will be used in their MDP Reconciliation. 

The MDP Reconciliation Results Report provides plans with all the inputs needed to understand how their MDP reconciliation is calculated, including plan-level and contract-level MDP payment amounts and MDP invoiced amounts. The calculation of the MDP reconciliation subtracts the Manufacturer Discount Payment Amount from the Manufacturer Discount Invoiced Amount. 

Note: An TPA Manufacturer Payment Portal (TPA MPP) User ID and password will not allow access to the MDP Reconciliation reports. For more information on how to access these reports please contact the TPA Helpdesk.