Coverage Gap Discount definition
Examples of Coverage Gap Discount in a sentence
I certify that I have made no alterations, amendments or other changes to this Medicare Coverage Gap Discount Program Agreement.
Neither the Company nor its Subsidiaries is, in any material respect, resubmitting or planning to resubmit to the government any data reported under the Medicaid Rebate Statute, Medicare Part B Drug Pricing requirements, 340B Program requirements, Veterans Health Care Act of 1992, or the Medicare Part D Coverage Gap Discount Program, or refunding any monies owed due to a resubmission.
For clarity, the term “Rebate Contract” shall include all Medicare Part D prescription drug plans, but shall not include the Medicare Coverage Gap Discount Program.
If you have any questions about the availability of a discount for the drugs you are taking or about the Medicare Coverage Gap Discount Program in general, please contact Member Services (phone numbers are printed on the back cover of this booklet).
The Medicare Coverage Gap Discount Program provides manufacturer discounts on Part D brand name drugs to Part D enrollees who have reached the coverage gap and are not already receiving “Extra Help.” A 50% discount on the negotiated price (excluding the dispensing fee and vaccine administration fee, if any) is available for those Part D brand name drugs from manufacturers that have agreed to pay the discount.
Express Scripts shall pay the Agency amounts equal to the Coverage Gap Discount Payments amounts allocated to the Agency, as specified in this Agreement, from Express Scripts’ or its Affiliate’s general assets (neither the Agency nor its EGWP Enrollees retain any beneficial or proprietary interest in Express Scripts’ or its Affiliate’s general assets).
The Company is not resubmitting or planning to resubmit to the government any data reported under the Medicaid Rebate Statute, Medicare Part B Drug Pricing requirements, 340B Program requirements, Veterans Health Care Act of 1992, or the Medicare Part D Coverage Gap Discount Program, or refunding any monies owed due to a resubmission.
The prescription drug benefit plan that provides coverage beyond the standard Part D benefit and is defined by CMS as other health or prescription drug coverage, and as such, the Coverage Gap Discount is applied before any additional coverage beyond the standard Part D benefit.
Subject to Section 2.2(a) above, Express Scripts agrees to periodically remit to the Agency amounts equal to 100% of the Coverage Gap Discount Payments received by Express Scripts within forty-five (45) days of the CMS Manufacturer Payment Date.
Section 1860D-14A(a) to the extent that the Addendum is a modification to the model agreement for use under the Medicare Coverage Gap Discount program and to the extent necessary to permit the Department and participating Manufacturers to timely execute the Addendum without the consultation and comment.