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CMS Updates Guidance on Medicare Part D Disclosure

    Client Alerts
  • March 30, 2007

The federal Centers for Medicare and Medicaid Services (“CMS”) recently posted updated guidance on disclosure notices to Medicare Part D eligible individuals on its website.  This information includes revised model creditable, non-creditable and personalized disclosure notices, which incorporate most of the changes to the notices published in May 2006 that were proposed in September 2006.  The new guidance applies to notices delivered after February 15, 2007.

Employers that provide prescription drug coverage to Medicare beneficiaries must disclose whether or not that coverage is “creditable” and whether it is primary or secondary to Medicare.  Disclosure is important because creditable coverage – where the value of the coverage equals or exceeds the value of Part D coverage – affects the premium that ultimately is payable by individuals who enroll in Part D after the end of their initial enrollment period.

The new guidance makes very few substantive changes.  However, it may simplify disclosure for some employers because CMS now states that employers may use the electronic disclosure provisions provided under DOL regulations for plan participants who have the ability to access the employer’s electronic information system on a daily basis as part of their work duties.  If this process is used, then the employer also must notify the plan participants that the participants are responsible for providing a copy of the electronic notice to their Medicare eligible dependents who are covered under the employer’s group health plan. 

Further information about Part D, creditable coverage and the required notice is available at the CMS website: