CMS-10171 2021 SPAP Template

Part D Coordination of Benefits Data (CMS-10171)

Release of the 2021 State Pharmaceutical Assistance and AIDS Drug Assistance Programs SPAP ADAP Module

Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers

OMB: 0938-0978

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Date:

May 28, 2020

Subject:

Release of the 2021 State Pharmaceutical Assistance and AIDS Drug Assistance
Programs (SPAP/ADAP) Module

The 2021 State Pharmaceutical Assistance and AIDS Drug Assistance Programs (SPAP/ADAP)
module is now ready for states/territories to proceed with their annual attestations. We are
requesting that SPAP/ADAP programs submit 2021 attestations by August 1, 2020. For states
that entered data for 2020, the 2021 SPAP/ADAP module will be prepopulated with any contact
and benefit data entered during the 2020 process.
You can access your existing SPAP/ADAP through the Health Plan Management System
(HPMS) at the following link: https://hpms.cms.gov and enter your User ID and Password. On
the HPMS Home Page, select SPAP/ADAP under Contract Management to access the
SPAP/ADAP start page and then select the Edit option. Update your current attestation as
needed and select the confirm option before submission.
We appreciate your efforts to help us maintain updated contacts/information for all Data Service
Agreements. For additional questions about your annual attestation please contact the following
mailbox: [email protected].


File Typeapplication/pdf
File TitleRelease of the 2021 State Pharmaceutical Assistance and AIDS Drug Assistance Programs (SPAP/ADAP) Module
Subject500
AuthorSamuel Kelsey
File Modified2020-05-28
File Created2020-05-28

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