Disclosure Requirements to CMS

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.

Employers must submit the online Disclosure to CMS Form each year to report their plan’s creditable coverage status.

That form must be submitted:

• Within 60 days of the start of your plan year (contract year, renewal year)
• Within 30 days if your plan ends
• Within 30 days of any change to your plan’s creditable coverage status

You can access the CMS’s Disclosure to CMS Guidance and Instructions webpage here.

This requirement for plan sponsors is outlined in 423.56 of CFR and is further clarified by the Centers for Medicare and Medicaid Services (CMS) guidance. Further information regarding creditable coverage and guidance can be found on the CMS website here.