Entities that 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." This disclosure is required whether the entity's coverage is primary or secondary to Medicare. Entities must disclose creditable coverage status to CMS using the online Disclosure to CMS Form found here. The disclosure should be completed annually no later than 60 days from the beginning of a plan year (contract year/renewal year), within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status.
Sponsors of non-calendar year plans should mark their calendars to make sure the disclosure to CMS is made within 60 days after the beginning of the plan year. (e.g., for an April 1 plan year, the CMS online disclosure should be made no later than May 30). An entity that does not offer outpatient prescription drug benefits to any Part D-eligible individual on the first day of its plan year is not required to complete the CMS disclosure form for that plan year.
For guidance on Creditable Coverage Disclosure to CMS, you may refer to this Legislative Brief or the CMS website. Please contact your Higginbotham representative if you have any additional questions.