Prescription Drug Discount Card

Transitional Assistance Program

In June 2004, CMS awarded IntegriGuard, LLC as a PSC the prized national contract to provide oversight to the Medicare Prescription Drug Discount Card-Transitional Assistance Program (PDDC-TAP).

What was the PDDC-TAP?

The Medicare Modernization Act (MMA) of 2003 required the implementation of a Prescription Drug Discount Card (PDDC) program to provide access to PDDC-eligible individuals throughout the United States. In addition, the MMA required that a Transitional Assistance Program (TAP) be provided for eligible individuals.

What tasks were involved with this national award?

As the PSC providing national oversight to the PDDC-TAP, IntegriGuard:

• Monitored drug pricing patterns
• Executed a plan for review of services rendered by PDDC sponsors
• Detected and prevented fraud and abuse related to enrollment, disenrollment, and complaint indicators
• Regularly reported to CMS any findings of potential fraud and abuse related to enrollment, disenrollment, and complaint indicators

How did IntegriGuard provide oversight?

IntegriGuard's approach to PDDC-TAP oversight included using the following elements:

• Probe studies to assess compliance of the PDDC sponsors with the TAP enrollment, eligibility, and financial accounting
• Site visits prompted by sentinel triggers to focus on process outcomes
• Education to assist PDDC sponsors in improving compliance with program requirements
• Audits to monitor PDDC sponsors' processes and financial records for Transitional Assistance (TA)
• Data analysis to identify potential fraud, waste, and abuse activity in the PDDC-TAP