Benefit Year (BY) Closeout Invoice Layouts

The Coverage Gap Discount Program (CGDP) Benefit Year (BY) Closeout invoice report layouts are available for Pharmaceutical Drug Manufacturers and Part D plan Sponsors to assist with understanding the format of the information provided in the BY Closeout invoice reports delivered via the Manufacturer Payment Portal (MPP).

The Manufacturer Reimbursement Summary Report, the Manufacturer Reimbursement Detail Report and the Upheld Dispute Tracking Report communicate the status of all upheld disputes for years no longer being invoiced. These reports will provide information whether correction of the disputed Prescription Drug Event (PDE) record has occurred that resolved the issue that led to the dispute and whether the correction resulted in a financial or non-financial change to the invoice data.

• Manufacturers should note that successful disputes can result in a full adjustment, partial adjustment, or no adjustment to the gap discount amount.

The Contract Reimbursement Summary Report and the Contract Reimbursement Detail Report communicate what Part D Plan Sponsors owe to each Pharmaceutical Drug Manufacturer for the benefit year closed out. The BY Closeout Invoice Reports provides invoices for a Part D Plan Sponsor to remit payment for any gap discounts invoiced in Q17 that were successfully disputed and for any successful disputes from previous quarters of the benefit year in which the Part D Plan Sponsor has only recently corrected.

• Not all contracts will receive a BY Closeout Invoice Report. These reports are only available to select Sponsors.