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Sponsor Information: Medicare Prescription Drug Discount Card
and Transitional Assistance Program

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Link to Medicare Health Plans Page

For general information on the Medicare Prescription Drug Discount Card
and Transitional Assistance Program, please visit http://www.cms.hhs.gov/medicarereform/drugcard/.

The recently enacted Medicare Prescription Drug Improvement and Modernization Act of 2003 authorizes the implementation of the Medicare-Approved Drug Discount Card Program. This program is designed to help people with Medicare with the cost of prescription drugs. Individuals will be able to enroll in a Medicare-approved prescription drug discount program beginning in spring of 2004. A key part of the Medicare-approved prescription drug discount card program is a subsidy of up to $600 a year for eligible lower-income beneficiaries. Individuals whose income is less than $12,124 each year or married couples whose income is less than $16,363 may qualify for this special help.

An interim final rule ( Text or PDF, 1.9 MB) establishing the Medicare Prescription Drug Discount Card Program went on display in the Federal Register on December 10, 2003. Also on display is a notice of solicitation ( Text or PDF, 97 KB). The notice announces CMS' intention to solicit applications from entities seeking a Medicare endorsement of their prescription drug discount card programs under the Prescription Drug and Medicare Improvement Act of 2003. View the general solicitation (Revised 12/23) (PDF, 429 KB or Zipped Word, 185 KB) outlining the requirements applicants must meet in order to obtain Medicare endorsement. Under this new program, certain Medicare managed care contractors may offer Medicare-approved drug discount card programs exclusively to their members, and there are special rules and instructions associated with obtaining such an endorsement. View the solicitation for Medicare managed care organizations planning to apply for an endorsement of an exclusive card program (Revised 12/23) (PDF, 811 KB or Zipped Word, 80 KB). Applications must be received at the Centers for Medicare & Medicaid Services (CMS) no later than 45 days after publication of the regulation.

A two-day pre-application conference was held on December 18-19 at CMS headquarters in Baltimore, Maryland. View Conference Agenda (PDF, 34K). View Conference Presentations.

You may also ask a question about the program's application process or operational policies. Questions posed through this website or by email to DrugCard@cms.hhs.gov will be screened and posted on this website. Click here to view the most recently updated frequently asked questions related to Operational Policy. Click here to view questions related to exclusive Sponsors.

CMS has setup a listserv for interested parties. By subscribing to this listserv, you will receive occasional updates on the Medicare Prescription Drug Discount Card and Transitional Assistance Program. Subscribe now.

Related Links:

• Approved Drug Card Sponsor Lists
• Waivers for Exclusive Drug Card Sponsors
• Press Release: HHS announces Immediate Steps to make Medicare-Approved Drug Discount Card Programs available next spring
• Overview of the Medicare Prescription Drug Discount Card and Transitional Assistance Program
• Documents published in the Federal Register (Note: Since the time these documents were sent to the Office of the Federal Register, the Public Law number has been assigned. It is Public Law 108-173.)
  • Notice ( Text or PDF, 97 KB)
    This notice is posted at www.cms.hhs.gov as a public courtesy. The official notice resides at the Office of the Federal Register, which may not be identical.
  • Interim final rule ( Text or PDF, 1.9 MB)
    This interim final rule is posted at www.cms.hhs.gov as a public courtesy. The official rule resides at the Office of the Federal Register, which may not be identical.
• Solicitations for parties interested in applying to become Medicare-endorsed sponsors
  • General solicitation (Revised 01/15/2004) (Zipped Word, 183 KB) or PDF, 430 KB)
  • Solicitation for managed care organizations (Revised 01/15/2004) (Zipped Word, 80 KB or PDF, 861 KB)
  • Data and Systems Requirements
    1. Enrollment/Eligibility Transactions
       1. File Formats (Zip, 130 KB) (UPDATED)
       2. EEVS Error Codes & Sponsor Codes (Zip, 17 KB)
       3. CMS User Access Form - This form, also called RACF, is used to provide access to CMS computer system(s) necessary for CMS business purposes. Only hard copy forms will be accepted before any official documentation denoting user IDs are provided to requesting entities. The following two links provide the two forms drug card sponsors must submit.
          
          CMS User Access Form for HPMS Access
          (A hard copy of this form must be submitted with your application. If you have not already done so, please submit this form as soon as possible to Kim August as indicated in the solicitation. Directions follow the form in the link provided above.)
          
          CMS User Access Form for NDM/Connect:Direct
          (This form is due no later than March 19, 2004 in hard copy to Robert Sears as indicated in the directions for the form.)
       4. CMS Connectivity Request (Zipped Word [6 KB] or PDF [116 KB] formats)
       5. Sponsor Systems Test Package (Zip, 47 KB)
    2. Drug Pricing Data Requirements - Zip File (Word and text files, 8 KB) (Revised 1/26/2004)
    3. Reporting and Monitoring Requirements PDF, 43KB
    4. Payment and Reconciliation Systems
    1. Payment and Reconciliation Requirements
    2. Transitional Assistance Monthly Report (Updated June 14, 2004)
    3. Transitional Assistance Monthly Report - Instructions (Updated June 15, 2004)
    4. Transitional Assistance Monthly Report - HTML Form Instructions
    5. Actions Required to Draw Funds by June 1, 2004 (PDF, 25 KB)
    6. Frequently Asked Questions (PDF, 21 KB)
    5. CMS Internet Architecture (Word, 770 KB)
    6. Network Security Customer Reference Guide (PDF, 205 KB)
    7. Drug Card System Frequently Asked Questions (PDF, 435 KB)
       (taken from technical conference calls with bidders and the EEVS_Sponsors email resource)
• Pre-application conference - December 18-19, 2003
  • View Conference Agenda (PDF, 34K)
  • View Conference Presentations
• Ask a question (Submit form or email DrugCard@cms.hhs.gov)

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