§423.2744. Prospective payments to Part D sponsors.

General rule. CMS will provide monthly prospective Manufacturer Discount Program payments to Part D sponsors for sponsors to advance manufacturer discounts as specified in § 423.2736(a) and reimburse network pharmacies as specified in § 423.2736(c).

Exception. CMS will not provide prospective Manufacturer Discount Program payments to employer group waiver plans.

Reconciliation. CMS will reconcile prospective Manufacturer Discount Program payments in accordance with subpart G of this part.

Manufacturer bankruptcy. In the event that an agreement holder declares bankruptcy, as described in title 11 of the United States Code, and as a result of such bankruptcy does not pay the invoiced amounts described in § 423.2756(a), CMS will adjust the Manufacturer Discount Program reconciliation amount for affected Part D sponsors to account for the invoiced amounts owed for the contract year being reconciled. The Government reserves the right to file a proof-of-claim and take any other action under bankruptcy law, as appropriate, to attempt to recover such unpaid amounts and any civil money penalties imposed by CMS under this part.