Instructions - Track Changes

CMS-367_Instructions_to_Labelers_August 2019_Track Changes.docx

Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

Instructions - Track Changes

OMB: 0938-0578

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Instructions to Labelers for CMS-367a, CMS-367b and CMS-367c


The following data fields are required for the relevant collections:


DATA FIELDS – CMS-367a


Labeler Code: First segment of the National Drug Code (NDC) that identifies the labeler. Numeric values; 5-digit field; right-justified; zero-padded.


Product Code: Second segment of the NDC. Alpha-numeric values; 4-digit field; right-justified; zero-padded.


Package Size: Third segment of the NDC. Alpha-numeric values; 2-digit field; right-justified; zero-padded.


Period Covered: Calendar quarter and year covered by the pricing data submission. Numeric 5-digit field; format: QYYYY.


Valid values for Q:


1 = January 1 - March 31

2 = April 1 - June 30

3 = July 1 - September 30

4 = October 1 - December 31


Valid values for YYYY: 4-digit calendar year equal to 1991 or later.


Average Manufacturer Price (AMP): The AMP per unit per product code for the period covered, based on sales. If a drug is distributed in multiple package sizes, there will be one “weighted” AMP for the product, which is the same for all package sizes. Compute to 7 decimal places, and round to 6 decimal places. Numeric values; 12-digit field: 5 whole numbers, the decimal point (‘.’) and 6 decimal places; right-justified; zero-padded for AMP values with fewer than 12 digits.


Best Price (BP): Per the statute and rebate agreement, the lowest price available per product code, regardless of package size. Compute to 7 decimal places and round to 6 decimal places. Zero or blank-filled for Non-Innovator Multiple Source drugs. Numeric values; 12-digit field: 5 whole numbers, the decimal point (‘.’) and 6 decimal places; right-justified; zero-padded for BP values with fewer than 12 digits.


Nominal Price (NP): Sales that meet the statutory/regulatory definition of NP. Labelers should determine an aggregate dollar amount (by adding up all package sizes), and report this aggregate NP dollar amount at the 9-digit NDC level. Total dollar figure, rounded to the nearest dollar. Zero or blank-filled if an NDC has no NP sales for the quarter/year being reported, and for every quarter/year in which an NDC is classified as a Non-Innovator Multiple Source drug. Numeric values; 9-digit field; 9 whole numbers; right-justified; zero-padded for NP values with fewer than 9 digits.


Customary Prompt Pay (CPP) Discount: Labelers should determine an aggregate dollar amount (by adding up all package sizes), and report this aggregate CPP dollar amount at the 9-digit NDC level. Total dollar figure, rounded to nearest dollar. Zero or blank-filled if the NDC has no CPP discount for the quarter/year being reported. Numeric values; 9-digit field; 9 whole numbers; right-justified; zero-padded for CPP Discount values with fewer than 9 digits.


Initial Drug Available for Line Extension: Identifies whether a line extension drug has an Initial Drug available for the quarter/year being reported. 1-character field.


Valid Values:


Y = Yes

N = No

X = X - Not an LE Drug

Z = Not Applicable (for quarters prior to 2Q2016, or for quarters in which the NDC or labeler was not active)

Initial Drug: Identifies the 9-digit NDC (from which a line extension drug is derived) with the highest additional rebate ratio (calculated as a percentage of AMP) for the quarter/year being reported. The Initial Drug’s additional rebate ratio is then used in the alternative URA calculation for the line extension drug. The Initial Drug should fall under the same corporation as the corresponding line extension drug, and must be active within the MDR Program at the time it is reported as an Initial Drug. Zero-filled if the Initial Drug Available for LE field contains a value of N, X, or Z. Numeric values; 9-digit field; right-justified; zero-padded.



DATA FIELDS – CMS-367b


Labeler Code: First segment of the National Drug Code (NDC) that identifies the labeler. Numeric values; 5-digit field; right-justified; zero-padded.


Product Code: Second segment of the NDC. Alpha-numeric values; 4-digit field; right-justified; zero-padded.


Package Size: Third segment of the NDC. Alpha-numeric values; 2-digit field; right-justified; zero-padded.


Month: Calendar month covered by the pricing data submission. Numeric values; 2-digit field; format: MM.


Valid values for MM:


01 = January

02 = February

03 = March

04 = April

05 = May

06 = June

07 = July

08 = August

09 = September

10 = October

11 = November

12 = December


Year: Calendar year covered by the pricing data submission. Numeric values; 4-digit field; format: YYYY.


Valid values for YYYY: 4-digit calendar year equal to 2007 or later.

Average Manufacturer Price (AMP): The AMP per unit per product code for the month/year covered, based on sales. If a drug is distributed in multiple package sizes, there will be one “weighted” AMP for the product, which is the same for all package sizes. Compute to 7 decimal places and round to 6 decimal places. Numeric values; 12-digit field: 5 whole numbers, the decimal point (‘.’) and 6 decimal places; right-justified; zero-padded for AMP values with fewer than 12 digits.



AMP Units: The total sum of all units included in the calculation of the AMP per product code for the monthly reporting period. If a drug is distributed in multiple package sizes, there will be one AMP unit value for the product, which is the same for all package sizes. Numeric values; 14-digit field: 11 whole numbers, the decimal point (“.”) and 2 decimal places; right-justified; zero-padded.



5i Threshold: A value indicating whether the reported AMP was calculated using the alternate 5i AMP methodology (i.e., a 5i Threshold value of “Y”), or using the standard (non-5i) methodology (i.e., a 5i Threshold value of “N”). A 5i Threshold value of “X” should be reported if the NDC was not classified as a 5i drug for the month/year combination being reported. For months prior to July 2014 (i.e., the month in which the 5i Threshold field was implemented), a 5i Threshold value of “Z” should be reported to indicate the field was not applicable. 1-character field.


Valid Values:

Y = Yes

N = No

X = Not a 5i drug

Z = Not Applicable



DATA FIELDS – CMS-367c


Labeler Code: First segment of the National Drug Code (NDC) that identifies the labeler. Numeric values; 5-digit field; right-justified; zero-padded.


Product Code: Second segment of the NDC. Alpha-numeric values; 4-digit field; right-justified; zero-padded.


Package Size: Third segment of the NDC. Alpha-numeric values; 2-digit field; right-justified; zero-padded.


Drug Category: Indicates whether the drug is single source (S), innovator multiple source (I), or non-innovator multiple source (N). 1 character field.


Valid values:


S = Single source

I = Innovator multiple source

N = Non-innovator multiple source


Unit Type: One of the 8 unit types by which a drug may be dispensed. 3-character field; left-justified; blank-filled for Unit Type values with fewer than 3 characters.


Valid values:


AHF = Injectable Anti-Hemophilic Factor

CAP = Capsule

EA = EACH

GM = Gram

ML = Milliliter

SUP = Suppository

TAB = Tablet

TDP = Transdermal Patch


FDA Approval Date: NDA (including Authorized Generic), ANDA, or BLA approval date. For covered outpatient drugs for which the FDA does not require approval, use 9/30/1990 or, if the drug was first marketed after 9/30/1990, the actual date first marketed. Numeric values; 8-digit field; format: MMDDYYYY.



Therapeutic Equivalence Code (TEC): FDA-assigned Therapeutic Equivalence Codes as found in the FDA’s Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. Alpha-numeric values; 2 digit field.


Valid values:


AA = Products in Conventional Dosage Forms Not Presenting Bioequivalence Problems    

AB = Products Meeting Necessary Bioequivalence Requirements assigned an FDA TEC of AB, or AB1 through AB9 

AN = Solutions and Powders for Aerosolization     

AO = Injectable Oil Solutions     

AP = Injectable Aqueous Solutions and, in Certain Instances, Intravenous Non-Aqueous  

AT = Topical Products     

BC = Extended-Release Dosage Forms (Capsules, Injectables, and Tablets)   

BD = Active Ingredients and Dosage Form With Documented Bioequivalence Problems

BE = Delayed-Release Oral Dosage Forms     

BN = Products in Aerosol-Nebulizer Drug Delivery Systems     

BP = Active Ingredients and Dosage Forms with Potential Bioequivalence Problems

BR = Suppositories or Enemas That Deliver Drugs for Systemic Absorption    

BS = Products Having Drug Standard Deficiencies     

BT = Topical Products with Bioequivalence Issues     

BX = Drug Products for Which the Data Are Insufficient To Determine Therapeutic Equivalence   

NR = Not Rated


Market Date: For S, I and N drugs marketed under an FDA-approved application (e.g. ANDA, BLA, NDA, NDA Authorized Generic), the earliest date the drug was first marketed under the application number by any labeler For drugs marketed without an FDA-approved application (e.g., OTC monograph, unapproved drug), the earliest date the drug was first marketed by any labeler. For all drugs (i.e., those marketed with or without an FDA-approved application) that were purchased or otherwise acquired from another labeler, the Market Date should be equal to the Market Date of the original product. If a Market Date falls on a date that is earlier than 9/30/1990, CMS will change it to 9/30/1990 in both the Medicaid Drug Rebate (MDR) system and the Drug Data Reporting for Medicaid (DDR) system since dates earlier than the start of the Medicaid Drug Rebate Program have no bearing on the program. Numeric values; 8-digit field; format: MMDDYYYY.


Termination Date: The date a drug is withdrawn from the market or the drug’s last lot expiration date. Zero or blank-filled for drug without Termination Dates. Numeric values; 8-digit field; format: MMDDYYYY.


Drug Type: Identifies a drug as prescription (Rx) or over-the-counter (OTC).

Numeric values; 1-digit field.


Valid Values:

1 = Rx

2 = OTC


OBRA’90 Baseline AMP: The AMP per unit for the period that establishes the OBRA’90 Baseline AMP for single source or innovator multiple source drugs. There will be one weighted Baseline AMP for the product, which applies to all package sizes. Compute to 7 decimal places and round to 6 decimal places. Zero or blank-filled if the NDC does not have an OBRA ’90 Baseline AMP, and for all Non-Innovator Multiple Source drugs. Numeric values; 12-digit field: 5 whole numbers, the decimal point (‘.’) and 6 decimal places; right-justified; zero-padded for OBRA ’90 Baseline AMP values with fewer than 12 digits.


Units Per Package Size (UPPS): The total number of units in the smallest dispensable amount for the 11-digit NDC. Numeric values; 11-digit field: 7 whole numbers, the decimal point (‘.’) and 3 decimal places; right-justified; zero-padded for UPPS values with fewer than 11 digits.


FDA Product Name: Drug name as it appears on FDA SPL listing. Alpha-numeric values; 63-character field; left-justified; blank-filled for FDA Product Names fewer than 63 characters.


Package Size Intro Date (PSID): The date the package size is first available on the market. Numeric values; 8-digit field; format: MMDDYYYY.


Purchased Product Date (PPD): The date the company currently holding legal title to the NDC first markets the drug under this NDC (this date can result, for example, from the purchase of an NDC from one company by another company, the re-designation of an NDC from one of a company’s labeler codes to another of that same company’s labeler codes, cross-licensing arrangements, etc.). Zero or blank-filled for drugs without Purchased Product Dates. Numeric values; 8-digit field; format: MMDDYYYY.


5i Drug Indicator: Identifies whether a product is a 5i Drug. 1-character field.


Valid Values:


Y = Yes

N = No






5i Route of Administration: Identifies the method by which the 5i drug is administered to a patient. If a product is not a 5i drug, a value of “000” (Not Applicable) should be reported. Numeric values; 3-digit field.


Valid Values:


000 =

Not Applicable

001 =

Implanted

002 =

Infused

003 =

Inhaled

004 =

Injected

005 =

Instilled



Covered Outpatient Drug (COD) Status:  A category that identifies how a product meets the statutory definition of a covered outpatient drug in accordance with sections 1927(k)(2) to 1927(k)(4) of the Social Security Act. Numeric values; 2-digit field.


Valid Values:


01 = Abbreviated New Drug Application (ANDA)

02 = Biological License Application (BLA)

03 = New Drug Application (NDA)

04 = NDA Authorized Generic

05 = DESI 5* – LTE/IRS drug for all indications

06 = DESI 6* – LTE/IRS drug withdrawn from market

07 = Prescription Pre-Natal Vitamin or Fluoride

08 = Prescription Dietary Supplement/Vitamin/Mineral (Other than Prescription
Pre-Natal Vitamin or Fluoride)

09 = OTC Monograph Tentative

10 = OTC Monograph Final

11 = Unapproved Drug – Drug Shortage

12 = Unapproved Drug – Per 1927(k)(2)(A)(ii)

13 = Unapproved Drug – Per 1927(k)(2)(A)(iii)


*NDCs with a COD Status of DESI 5/6 are not eligible for coverage or rebates under the Medicaid Drug Rebate Program.


FDA Application Number/OTC Monograph Number: For drugs with a COD status of ANDA, BLA, NDA, or NDA Authorized Generic, this is the application number (assigned by the FDA for approval to market a drug or biological in the United States) under which the NDC is currently marketed. Numeric values; 7-digit field; padded with leading zeros as needed.


For drugs with a COD status of OTC Monograph Tentative or Final, this is the FDA’s regulatory citation for the OTC. Alpha-numeric values; 7-digit field. For drugs with a COD Status of OTC Monograph Final, the first four characters are a constant of “PART”; the last three characters are the numeric values for the appropriate regulatory citation for the product (e.g., “225”). For drugs with a COD Status of OTC Monograph Tentative, the first four characters are a constant of “PART”; the last three characters are the numeric values for the appropriate regulatory citation for the product, or three zeros if a Monograph Number is not available.


For drugs with a COD Status other than ANDA, BLA, NDA, NDA Authorized Generic, OTC Monograph Final, or OTC Monograph Tentative, the FDA Application No./OTC Monograph No. field should be zero-filled.


Line Extension Drug Indicator: Identifies whether a product is a line extension drug as defined in Section 1927 (c)(2)(C) of the Social Security Act, including whether the drug is excluded from the statutory definition of a line extension on the basis of being an abuse-deterrent formulation (ADF). Labelers seeking an ADF exclusion at the time a drug is initially reported in DDR should submit an initial value of “R” in this field for CMS review and approval. 1-character field.

Valid Values:


Y = Yes

N = No (i.e., neither LE nor ADF)

R = Request for ADF Exclusion

E = Excluded (Due to ADF)*


*NOTE: This value may only be assigned by CMS and cannot be reported by a labeler.

Reactivation Date: The date on which a terminated product is re-introduced to the market. (Note: This field may only be submitted online via DDR and is NOT part of the actual File Format.)


Labelers will have two data reporting options within DDR: first, they may key their data online on an NDC-by-NDC basis; second, they may transfer a saved file to DDR. Labelers that key their data online will have an interactive “pop-up” help function when the DDR has detected a potential data error. Labelers that opt to transfer their data via a file to DDR can check the system periodically for a report that outlines any errors detected, as well as alerts for potential errors or data issues. These File Transfer Edit Reports include the following error/ alert messages, along with instructions to the labeler to correct each data issue:



New Message

Type

Reason For Occurrence

E1

Product record contains a missing or invalid labeler code

Error

Labeler code (NDC1) on the product record is blank or does not exist in the database.

E2

Pricing record contains a missing or invalid labeler code

Error

Labeler code (NDC1) on the price record is blank or does not exist in the database.

E3

Missing or incorrect product code

Error

Product code (NDC2) is blank or incorrect format or value.

E4

Missing or incorrect package size

Error

Package size code (NDC3) is blank or incorrect format or value.

E5

Deleted product - rejected by CMS

Error

Product or package size has been deleted by CMS.

E6

Drug Category is blank or is not S, I or N

Error

Drug Category field may not be blank and must be S, I or N.

E7

Missing or invalid TEC

Error

TEC is blank or is invalid code.

E8

Missing Drug Type or drug type is not 1 or 2

Error

Drug Type cannot be blank and must be 1 or 2.

E9

OBRA ’90 Base AMP required

Error

Base AMP cannot be blank or contains zero when the drug category is S or I and the market date is earlier than 10/01/1993.

E10

Base AMP change is rejected

Error

Pricing changes after 12 quarters are not allowed.

E11

Base AMP is less than 6 decimal places and/or is not numeric

Error

Base AMP must be both numeric and 6 decimal places.

E12

Reserved

Error

Reserved

E13

Term Date is invalid and/or earlier than the Market Date

Error

Termination Date must be a valid date and later than the Market Date, and should be zero or blank-filled if not present.

E14

Missing or invalid Unit Type

Error

Unit Type is blank or not a valid value.

E15

UPPS is less than 3 decimal places and/or is not numeric and/or is missing or invalid

Error

Units Per Package Size must be both numeric and 3 decimal places and cannot be blank.

E16

Future FDA Approval Date not allowed

Error

FDA Approval Date must be equal to current quarter or earlier.

E17

Missing or invalid Market Date

Error

Market Date cannot be blank and must be a valid date.

E18

Market Date not allowed

Error

Market Date cannot be greater than current quarter plus one.

E19

Invalid FDA Approval Date

Error

FDA Approval Date must be a valid date.

E20

Market Date is less than FDA Approval Date

Error

Market Date must be equal to or greater than the FDA Approval Date.

E21

Missing FDA Drug Name

Error

FDA Drug Name cannot be blank.

E22

Missing or invalid DESI

Error

DESI cannot be blank and must equal 2, 3, 4, 5 or 6.

E23

Product code does not exist

Error

Product code (NDC2) not found - pricing rejected.

E24

Missing year and/or quarter

Error

Quarter and/or year is blank (QYYYY).

E25

Quarter must be 1, 2, 3, or 4

Error

Quarter is not equal to 1, 2, 3 or 4.

E26

Invalid year

Error

Year reported is not numeric or is greater than current year.

E27

Year earlier than start of rebate program

Error

Year on the price record cannot be earlier than 1991.

E28

Future quarterly pricing not allowed

Error

Pricing quarter cannot be greater than current quarter.

E29

Best Price must contain 6 decimal places

Error

Best Price is less than 6 decimal places.

E30

Best Price must be present, numeric and greater than zero for category S or I drugs

Error

Best Price is blank, non-numeric, or zero.

E31

AMP must contain 6 decimal places

Error

AMP is less than 6 decimal places.

E32

AMP must be present, numeric, and greater than zero

Error

AMP is blank, non-numeric, or zero.

E33

Package size code does not exist

Error

Package size code (NDC3) not found - pricing rejected.

E34

Pricing change rejected

Error

Pricing changes not allowed after 12 quarters.

E35

AMP change not approved by CMS

Error

Only Best Price change approved by CMS.

E36

Best Price change not approved by CMS

Error

Only AMP change approved by CMS.

E37

Monthly pricing data rejected

Error

Monthly pricing changes not allowed after report period ends.

E38

UPPS cannot contain decimals when Unit Type is EA

Error

UPPS cannot contain decimals when Unit Type is EA.

E39

Pricing data submitted for a period more than 4 quarters after Termination Date

Error

Labeler submitted pricing data greater than 4 quarters after Termination Date. Review for accuracy.

E40

Missing month and/or year

Error

Month and/or year is blank (MMYYYY).

E41

Month must be a two-digit numeric value

Error

Month must be equal to 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, or 12.

E42

Year earlier than start of monthly data collection

Error

Year on the price record cannot be earlier than 2007.

E43

Future monthly pricing not allowed

Error

Pricing month cannot be greater than current month.

E44

Package size is terminated

Error

Pricing record cannot be used to change AMP and/or Best Price because package size was terminated for the quarter specified. Only active package sizes can be used to change pricing.

E45

Monthly pricing data submitted for monthly periods beyond Termination Date

Error

Labeler submitted monthly pricing data greater than Termination Date. Review for accuracy.

E46

Reserved

Error

Reserved

E47

Reserved

Error

Reserved

E48

Reserved

Error

Reserved

E49

Pricing change submitted after expiration date

Error

Labeler submitted change after specified date.

E50

Product code access denied

Error

User does not have access to this product code.

E51

Labeler code access denied

Error

User does not have access to this labeler code.

E52

Customary Prompt Pay Discount is missing, not numeric, and/or is not equal to a value of zero or greater

Error

Customary Prompt Pay Discount must be present, numeric and equal to a value of zero or greater.

E53

Nominal Price is missing, not numeric and/or is not equal to a value of zero or greater

Error

Nominal Price must be present, numeric and equal to a value of zero or greater.

E54

Reserved

Error

Reserved

E55

Reserved

Error

Reserved

E56

DRA Base AMP submitted outside allowable timeframe

Error

The submission of DRA Base AMP is subject to requirements of CMS-2238-FC.

E57

Multiple package size error – labeler submitted different DRA Base AMPs across multiple package sizes of the same product

Error

DRA Base AMP was not weighted as required. Review/Correct.

E58

Market Date change requires additional pricing

Error

Market Date change to earlier date results in additional pricing due from labeler. If Market Date change is correct, labeler must process the change online in DDR.

E59

Market Date change invalidates labeler pricing

Error

Market Date change to later date causes submitted pricing for earlier quarters to become invalid. If Market Date change is correct, labeler must process the change online in DDR.

E60

Purchased Product Date field not properly reported

Error

Purchased Product Date must be supplied. If Market Date is within current reporting period, or if the product is being reported late and there is no Purchased Product Date, then the Purchased Product Date should be blank or zero-filled.

E61

Purchased Product Date entry must be performed manually online via DDR

Error

Purchased Product Date entered is later than the Market Date or previously entered Purchased Product Date; therefore, prior period pricing may exist. This action will cause the removal/deletion of previously calculated URA values for the submitted pricing. Change/entry of Purchased Product Date must be performed manually in DDR.

E62

Changing a Purchased Product Date to an earlier date results in additional pricing due from labeler

Error

Purchased Product Date entered is earlier than the previous Purchased Product Date; therefore, additional pricing is due from the labeler. If the new Purchased Product Date is correct, labeler must process the change online in DDR.

E63

Purchased Product Date is less than the Market Date

Error

Purchased Product Date must be equal to or greater than the Market Date.

E64

Purchased Product Date not allowed

Error

Purchased Product Date cannot be greater than current quarter plus one.

E65

Package Size Intro Date not allowed

Error

Package Size Intro Date cannot be greater than current quarter plus one.

E66

Package Size Intro Date is less than Market Date or Purchased Product Date (if PPD present)

Error

Package Size Intro Date must be equal to or greater than the Market Date or the Purchased Product Date (if PPD present).

E67

Missing or Invalid Package Size Intro Date

Error

Package Size Intro Date cannot be blank and must be a valid date.

E68

Invalid Package Size Intro Date

Error

At least one Package Size Introduction Date must be equal to Market Date or Purchased Product Date.

E69

Changing a Package Size Introduction Date to an earlier date results in additional pricing due from labeler

Error

Package Size Introduction Date entered is earlier than the previous Package Size Introduction Date; therefore, additional pricing is due from the labeler. If the new Package Size Introduction Date is correct, labeler must process the change online in DDR.

E70

Package Size Introduction Date entry must be performed manually online via DDR

Error

Package Size Introduction Date entered is later than the previously entered Package Size Introduction Date; therefore, prior period pricing may exist. This action will cause the removal/deletion of previously submitted AMP values. Change/entry of Package Size Introduction Date must be performed manually in DDR.

E71

Termination Date change invalidates existing labeler data

Error

Termination Date change to an earlier date causes submitted pricing for earlier months and/or quarters to become invalid. If Termination Date is correct, labeler must process the change online in DDR.

E72

Multiple package size error – labeler submitted different Market Dates across multiple package sizes of the same product

Error

Market Date was not the same across all package sizes for the same product. Review/Correct.

E73

Multiple package size error – labeler submitted different FDA Approval Dates across multiple package sizes of the same product

Error

FDA Approval Date was not the same across all package sizes for the same product. Review/Correct.

E74

Multiple package size error – labeler submitted different Purchased Product Dates across multiple package sizes of the same product

Error

Purchased Product Date was not the same across all package sizes for the same product. Review/Correct.

E75

Pricing quarter prior to Market Date and/or Purchased Product Date

Error

Pricing quarter must be after the Market Date or Purchased Product Date if one is present unless pricing quarter is being submitted to establish the product’s OBRA ’93 Baseline AMP.

E76

AMP Units must contain 2 decimal places

Error

AMP Units value is less than 2 decimal places.

E77

AMP Units must be present, numeric and greater than or equal to zero

Error

AMP Units value is blank, non-numeric or less than zero.

E78

Monthly pricing change rejected

Error

Monthly pricing changes not allowed after 36 months.

E79

Multiple package sizes – AMP Units problem

Error

AMP Units must be the same value across all package sizes.

A1

Pricing submission equals current price

Alert

Submitted pricing data equaled the pricing data already in the database.

A2

Drug Category change not allowed

Alert

Drug Category has a different value than the current value. Cannot change from S/I to N or vice versa without CMS approval.

A3

Warning: Unit Type changed

Alert

Unit Type change often requires changes to UPPS and price. Review and adjust as needed

A4

Base AMP must be zero-filled if Market Date is greater than 9/30/1993 or for N drugs

Alert

Database uses AMP submitted for Base AMP quarter. Base AMP not required for N drugs.

A5

Market Date changes are not allowed

Alert

Market Date cannot be changed after 12 quarters without prior CMS approval.

A6

DESI change not allowed

Alert

DESI cannot be changed from a value of 2, 3, or 4 to a value of 5 or 6 or vice-versa.

A7

FDA Approval Date may not be after Market Date

Alert

Previous FDA Approval Date remains in database.

A8

Multiple package size OBRA ’90 Base AMP problem

Alert

OBRA ‘90 Base AMP was not weighted as required. CMS used highest submitted Base AMP which will result in highest possible AMP. Review/correct.

A9

Reserved

Alert

Reserved

A10

Multiple package size AMP problem

Alert

AMP was not weighted as required. CMS used highest submitted AMP which will result in highest possible AMP. Review/correct.

A11

Multiple package size FDA Approval Date problem

Alert

Initial FDA Approval Date does not change when new package size is added.

A12

Multiple package size Market Date problem

Alert

Initial Market Date does not change when new package size is added.

A13

Drug Category change made

Alert

Drug Category changed from S to I or vice-versa.

A14

Terminated package size - latest active Best Price used

Alert

When all package sizes are terminated, the best price from the last active quarter is used.

A15

Best Price greater than AMP

Alert

Best Price cannot be greater than AMP. CMS changed Best Price to equal AMP. Review/correct

A16

Multiple package size – Best Price problem

Alert

Best Price must be lowest price regardless of package size and the same value across all package sizes. CMS used lowest submitted Best Price which will result in highest possible URA. Review/correct.

A17

DRA Base AMP must be zero-filled if Market Date > 6/30/2007 or when drug category is “N”

Alert

DRA Base AMP is not required for NDCs with Market Dates > 6/30/2007 or for N drugs.

A18

Reserved

Alert

Reserved

A19

DRA Base AMP must be a valid numeric value with no blanks or special characters

Alert

DRA Base AMP, if supplied, must be numeric; 5 whole positive number and 6 decimals or must be zero-filled.

A20

Terminated package size – latest active AMP used

Alert

When all package sizes are terminated, the AMP from the last active quarter is used.

A21

Best Price not required for N drugs

Alert

Best Price not required for N drugs.

A22

Reserved

Alert

Reserved

A23

Reserved

Alert

Reserved

A24

Nominal Price invalid

Alert

For all active package sizes, Nominal Price must be a positive dollar value or zero.

A25

Multiple Package Size – AMP not submitted for all package sizes

Alert

AMP value for all package sizes not submitted. AMP for submitted package size will be stored for all active packages. Review/Correct.

A26

Product Record requires the submission of a quarterly pricing record (QYYYY) to establish the Baseline AMP

Alert

A new S or I product record with a Market Date earlier than the current quarter requires the submission of the quarterly AMP value needed to establish the product’s OBRA ’93 Baseline AMP.

A27

Nominal Price submitted for N drug – price will not appear in DDR

Alert

Nominal Price is not required for an N drug; therefore, the submitted price will not appear in DDR.

A28

Customary Prompt Pay Discount and/or Nominal Price submitted for terminated package size

Alert

When the last active package size of a product is terminated and it is within four quarters after the Termination Date, the Customary Prompt Pay Discount and/or Nominal Price field should be zero-filled for those four quarters.

A29

Valid Purchased Product Date value in database

Alert

Purchased Product Date exists in the database. Removal of PPD can be performed through the online system.

A30

Submitted Package Size Introduction Date is earlier than current reporting period

Alert

The Package Size Introduction Date submitted is earlier than the current reporting period; therefore, prior period monthly AMP values were automatically populated and prior quarterly NP and CPP values were zero-filled. These populated values all require certification – please review, correct where appropriate, and certify.

A31

Product Termination Date removed/changed to a later date

Alert

Removing or changing a product Termination Date to a later date results in additional pricing due from labeler. Review, enter missing pricing and certify any entered pricing.

A32

Reserved

Alert

Reserved

A33

Monthly AMP Units increased/decreased by 40% from last month.

Alert

Monthly AMP Units increased/decreased by 40% from last month, please review/correct.

A34

Reserved

Alert

Reserved

A35

AMP Units not required prior to October 2010

Alert

AMP Units are not required for periods prior to October 2010. Unit information not kept.

A36

AMP reported as 0.000001

Alert

AMP reported as 0.000001. Verify this is the actual AMP value for the NDC. If the AMP equals 0.000001 because the calculated AMP is negative or zero, report the most recent prior AMP.



Form CMS-367a is used by manufacturers on a quarterly basis, to transmit pricing data for each of their covered outpatient drugs to CMS either electronically or via file transfer. The use of Form CMS-367a on a quarterly basis by manufacturers is considered mandatory under the authority of Section 1927 of the Social Security Act and the National Drug Rebate Agreement. Under the Privacy Act of 1974 any personally identifying information obtained will be kept private to the extent of the law.


According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-0578. The time required to complete this information collection is estimated to average 34.8 hours per response, including the time to review instructions, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleInstructions to Labelers for CMS-367a, CMS-367b and CMS-367c
AuthorCMS
File Modified0000-00-00
File Created2021-01-14

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