Medicare Part D Disclosure to CMS

    Each year, employers whose health plans provide prescription drug coverage to Medicare-eligible individuals must disclose to the Center for Medicare and Medicaid Services (CMS) whether that coverage is creditable or non-creditable. This process is referred to as “Disclosure to CMS”.   Disclosure to CMS is required whether the entity’s coverage is primary or secondary to Medicare.   For information on determining whether prescription drug coverage is “creditable”, visit CMS’ Creditable Coverage website.

    The disclosure must be submitted to CMS on an annual basis, and also upon any change that affects whether the prescription drug coverage is creditable.  At a minimum, the Disclosure to CMS Form must be provided at the following times:

    • Within 60 days after the beginning date of the plan year for which the disclosure is provided (since 2016 is a leap year, for calendar year plan years, this means the disclosure is due FEBRUARY 29TH (not March 1st);
    • Within 30 days after the termination of the prescription drug coverage provided by the plan; and
    • Within 30 days after any change in the creditable coverage status of the prescription drug coverage provided by the plan.

    The sole method for complying with this requirement is through completion of the online Disclosure to CMS Form on the CMS Creditable Coverage web page.  CMS has also provided instructions for detailed descriptions of the form’s required data fields and guidance on how to complete the form.

    CMS frequently updates the published forms and material related to Part D Compliance. For current updates, please visit the Creditable Coverage section of the CMS website.

    By csmith

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