Use the Manufacturer Contact Change Form (367d) to update CMS with changes to manufacturer Legal, Invoice and Technical Contacts.  The form may be faxed to Drug Rebate Operations, (410) 786-0390.  The form is downloadable in a PDF format by clicking on the link in the "Downloads" section below.

Use the State Contact Change Form (368) to update CMS with changes to state Technical, Program Policy, and Rebate Contacts.  The form may be faxed to Drug Rebate Operations, (410) 786-0390.  The form is downloadable in a PDF format by clicking on the link in the "Downloads" section below.

Drug Manufacturers who need to report or certify their data should use the Application for Access to the Centers for Medicare and Medicaid Services Computer Systems (Form CMS-20037) to apply for access to the Drug Data Reporting for Medicaid (DDR) System. Note that access to manufacturer data will be designated by each labeler's Technical Contact. The form must contain a labeler code(s), original signature and social security number and must be mailed to the Drug Rebate Operations team at the address provided in the instructions. The form is downloadable in a PDF format by clicking on the link in the "Downloads" section below.

Downloads
View the Manufacturer Contact Change Form [PDF, 67KB] View the State Contact Change Form [PDF, 9KB] View the DDR CMS User ID ACCESS Form and Instructions [PDF, 518KB]
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Page Last Modified: 11/18/2009 10:15:11 AM
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