---
kind: "section"
citation: "42 C.F.R. § 423.2736"
title: "42"
number: "423.2736"
heading: "Requirement for point-of-sale discounts."
url: "https://uscodex.org/cfr/42/423.2736"
---

# §423.2736. Requirement for point-of-sale discounts.

- (a) **Point-of-sale discounts.** Part D sponsors must provide applicable discounts on applicable drugs at the point of sale on behalf of the manufacturer. As part of this process, plan sponsors must determine—
  - (1) Whether an enrollee is an applicable beneficiary as described in [§ 423.100](/cfr/42/423.100.md);
  - (2) Whether a drug is an applicable drug as described in [§ 423.100](/cfr/42/423.100.md); and
  - (3) The amount of the discount, in accordance with [§ 423.2712](/cfr/42/423.2712.md).
- (b) **Direct member reimbursement (DMR).** Part D sponsors must provide applicable discounts on claims for applicable drugs submitted by applicable beneficiaries as DMRs, including out-of-network and in-network paper claims, if such claims are payable under the Part D plan. While the sponsor must account for the discount in adjudicating the DMR request and the associated PDE submitted to CMS, the point-of-sale requirement does not apply.
- (c) **Pharmacy prompt payment.** Part D sponsors must reimburse a network pharmacy (as defined in [§ 423.100](/cfr/42/423.100.md)) the amount of the applicable discount within the applicable number of calendar days (as defined in [§ 423.100](/cfr/42/423.100.md)) of the date of dispensing (as defined in [§ 423.100](/cfr/42/423.100.md)) of an applicable drug, consistent with [§ 423.520](/cfr/42/423.520.md).
- (d) **Prescription drug event (PDE) requirements.** Part D sponsors must report the applicable discounts made available to their enrollees under the Manufacturer Discount Program on the PDE records associated with such discounts.
- (e) **Retroactive adjustments.** Part D sponsors must make retroactive adjustments to applicable discounts as necessary to reflect applicable changes, including changes to the claim, beneficiary eligibility, or benefit phase determined after the date of dispensing.

## Notes

### Source

Source: 91 FR 17594, Apr. 6, 2026, 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.