SAM #261614

Planned Follow-On Contract for Payment Processing and Modernization Services for Medicare Drug Programs

CMS is planning a two-year follow-on contract with Palmetto GBA to continue payment processing and modernization for pharmaceutical manufacturers and Part D plans. - Contract covers payment processing for programs like Coverage Gap Discount Program and Medicare Part B and D rebate programs - Modernization efforts include: - Integrating the GLOBE program into the Manufacturer Payment Portal - Migrating infrastructure to CMS AWS Cloud Enclave - The follow-on contract bridges the period from August 8, 2025, to August 7, 2026, with a full recompete planned for Fall 2027 - No specific product part numbers or quantities are listed - Services focus on operational continuity and technology upgrades - Palmetto GBA is the incumbent service provider - No OEMs or commercial product manufacturers are named

Description

This contract defines the requirements for a Third Party Administrator (TPA), acting on behalf of the Centers for Medicare and Medicaid Services (CMS), for pharmaceutical manufacturer invoicing activities. Medicare programs that require pharmaceutical manufacturer invoicing include: the Coverage Gap Discount Program (CGDP), the Manufacturer Discount Program (MDP), the Inflationary Rebate program, and the Discarded Drug Refund Program. We refer to these programs collectively as “Medicare Drug Manufacturer Invoicing Activities” or “MDMIA.”. The TPA functions required under this contract include development, testing, implementation, operation, maintenance, and customer service necessary to meet the needs of CMS, pharmaceutical manufacturers, Part D sponsors, and contracted CMS personnel involved with the operation and administration of the MDMIA, in accordance with the provisions of the legislation listed below.

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