Dear Manufacturer Technical and Invoice Contacts,
Section 9008 of the Affordable Care Act (ACA) established the Branded Prescription Drug Fee (BPD) Program, in which Medicaid and the other specified government drug programs (Medicare Part B, Medicare Part D, TRICARE, Department of Veterans Affairs (VA), and the Department of Defense (DOD)), are required to report annual drug sales information to the Department of Treasury. In order for Medicaid to accurately calculate the Medicaid sales dollars, it is imperative that the product data (e.g., Average Manufacturer Price (AMP), Unit Rebate Amount (URA)), and state drug utilization data (SDUD) reported in the Medicaid Drug Program system (MDP) be correct and up-to-date.
It is the expectation that Manufacturers routinely monitor MDP product (e.g., drug category, product termination date, etc.) and pricing (e.g., AMP, BP) to ensure accuracy. Additionally, manufacturers should verify correctness of SDUD units and reimbursement amounts reported to CMS in comparison to their state rebate invoices. If a manufacturer has reached agreement on an adjustment and/or dispute with a state and that agreement is not reflected in MDP by the due date of the next quarterly data transmission from the state, the manufacturer should contact the state to confirm that the adjusted data has been reported to CMS.
The next annual fee calculation will use the data submitted by states for all quarters in 2022. If there are differences between quarterly rebate invoices and the state-reported utilization data (units/reimbursement amounts) in MDP for the same quarter in 2022, we request that a manufacturer contact the appropriate state’s Technical Contact (copying CMS at MedicaidBPD@cms.hhs.gov) regarding the difference. A list of state Technical Contacts can be found at https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/index.html.
Note: We have sent this information to the Manufacturers’ Technical and Invoice Contacts for the Medicaid Drug Rebate Program (MDRP). If you are not your company’s contact for the branded prescription drug fee (BPD) program, please forward to your company’s BPD contact, and be aware that he/she may need your assistance using/interpreting the rebate data being used for the annual sales fee to more effectively evaluate whether disputes are warranted, and how to present the data in such instances.
Thank you for your cooperation with this effort. If you have any questions, please feel free to contact us via this email resource box, MedicaidBPD@cms.hhs.gov.
CMS Medicaid BPD Team