Creditable Coverage Initial Notice
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The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added a new prescription drug program to Medicare. Under those provisions, most entities that currently provide prescription drug coverage to Medicare Part D eligible individuals must disclose to the Centers for Medicare & Medicaid Services (CMS) whether the coverage is "creditable prescription drug coverage" (Disclosure Notice).
The regulation at 42 CFR 423.56(e) requires all entities described in the regulation disclosure to CMSA whether the prescription drug coverage that is offered to Medicare Part De eligible individuals is creditable or non-creditable. At a minimum, disclosure to CMS must be made at the following times:
- For plan years that end in 2006, disclosure of creditable coverage status must be provided no later than March 31, 2006.
- For plan years that end in 2007 and beyond, disclosure of creditable coverage status must be provided within 60 days after the beginning date of the plan year for which the entity is providing the disclosure to CMS.
- Within 30 days after the termination of the prescription drug plan; and
- Within 30 days after any change in the creditable coverage status of the prescription drug plan.
An entity that is required to provide the Disclosure Notice through completion of the disclosure form on the CMS Creditable Coverage Disclosure Web Page at http://www.cms.hhs.gov/creditablecoverage.
CMS recently released Creditable Coverage Notice to CMS Guidance at http://www.cms.hhs.gov/CreditableCoverage/Downloads/Disclosure2CMSGdnc.pdf.
For additional information related to Creditable Coverage go to the CMS web site Creditable Coverage Overview at http://www.cms.hhs.gov/CreditableCoverage/01_Overview.asp#TopOfPage
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