Final settlement amount
Final settlement amount means the final payment amount that CMS owes and ultimately pays to a Part D sponsor, or that a Part D sponsor owes and ultimately pays to CMS, with respect to a Part D contract that has consolidated, nonrenewed, or terminated. The final settlement amount is calculated by summing final retroactive payment adjustments for a specific contract that accumulated after that contract ceases operation but before the calculation of the final settlement amount and all of the following applicable reconciliation amounts that have been completed as of the date the notice of final settlement has been issued, without accounting for any data submitted after the data submission deadlines for calculating these reconciliation amounts: (1) Risk adjustment reconciliation, as applicable (described in 422.310 of this chapter). (2) Part D annual reconciliation (described in 423.343). (3) Coverage Gap Discount Program annual reconciliation (described in 423.2320). (4) MLR remittances (described in 422.2470 of this chapter and 423.2470).