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Notes

§423.2320. Payment processes for Part D sponsors.

42 C.F.R. § 423.2320

(a)
Interim payments. CMS provides monthly interim coverage gap discount program payments as necessary for Part D sponsors to advance coverage gap discounts to beneficiaries.
(b)
Coverage Gap Discount Reconciliation. CMS reconciles interim payments with invoiced manufacturer discount amounts made available to each Part D plan's enrollee under the Coverage Gap Discount Program.
(c)
Manufacturer bankruptcy. In the event that a manufacturer declares bankruptcy, as described in Title 11 of the United States Code, and as a result of the bankruptcy, does not pay the quarterly invoices described in § 423.2315(b)(10) used for a particular contract year's Coverage Gap Discount Reconciliation described in paragraph (b) of this section, CMS adjusts the Coverage Gap Discount Reconciliation amount of each of the affected Part D sponsors to account for the total unpaid quarterly invoiced amount owed to each of the Part D sponsors for that particular contract year being reconciled.
Notes, amendments, and revision history

Amendments

[77 FR 22172, Apr. 12, 2012, as amended at 80 FR 7965, Feb. 12, 2015; 91 FR 17593, Apr. 6, 2026]

Source

Source: 77 FR 22172, Apr. 12, 2012, unless otherwise noted.

Authority

Authority: 42 U.S.C. 1302, 1306, 1395w-101 through 1395w-152, and 1395hh.

Source

Source: 70 FR 4525, Jan. 28, 2005, unless otherwise noted.

Amendments

[77 FR 22172, Apr. 12, 2012, as amended at 80 FR 7965, Feb. 12, 2015; 91 FR 17593, Apr. 6, 2026]