Blogging Employee Benefits

January 9, 2006

Guidance on Creditable Coverage Notice to CMS

Filed under: CMS, Medicare Part D — Fuguerre @ 6:06 pm

If an employer-sponsored union group health plan provides presciption drug coverage to individuals who are eligible for Medicare Part D, then the plan sponsor must provide notice to the Centers for Medicare & Medicaid Services (CMS) whether the plan’s coverage is “creditable prescription drug coverage.” CMS has published guidance relating to the form, manner, and timing for meeting that notification requirement. [Disclosure to CMS Guidance]

All entities described in the regulation at 42 CFR 423.56(b) must disclose to CMS whether the prescription drug coverage offered to Part D eligible individuals is creditable or non-creditable. Entities that contract with Medicare directly as a Part D plan or that contract with a Part D plan to provide qualified prescription drug coverage are exempt from the disclosure requirement. 

Entities are to make the disclosure to CMS by completion of an on-line form on the CMS Creditable Coverage Disclosure Web Page. See Disclosure to CMS Form.

The Disclosure Notice must be made to CMS on an annual basis and upon any plan change that affects whether the drug coverage is creditable.  The initial Disclosure Notice must be provided to CMS by 3/31/06.

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