April 2023 Compliance Recap - Bim Group

April 2023 Compliance Recap

READ TIME: 4 MINUTES

While the compliance focus for April continues to be on the Prescription Drug Data Collection (RxDC) of the Consolidated Appropriations Act, 2021, the Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D.

2024 Benefit Parameters for Medicare Part D Creditable Coverage Disclosures Announced

The Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D. These factors are used to determine the actuarial value of defined standard Medicare Part D coverage under CMS guidelines.

Each year, Medicare Part D requires that employers offering prescription drug coverage to Part D eligible individuals (including active or disabled employees, retirees, COBRA participants, and beneficiaries) disclose to those individuals and CMS whether the prescription plan coverage offered is creditable or non-creditable. Creditable coverage meets or exceeds the value of defined standard Medicare Part D coverage.

Insurance carriers and providers of the prescription benefit will typically notify the plan sponsor if their prescription plan is creditable or non-creditable. The 2024 parameters for Medicare Part D are:

  • Deductible: $545 (up from $505 in 2023)
  • Initial coverage limit: $5,030 (up from $4,660 in 2023)
  • Out-of-pocket threshold: $8,000 (up from $7,400 in 2023)
  • Total covered Part D spending at the out-of-pocket expense threshold for beneficiaries who are not eligible for the coverage gap discount program: $11,477.39 (up from $10,516.25 in 2023)
  • Estimated total covered Part D spending at the out-of-pocket expense threshold for beneficiaries who are eligible for the coverage gap discount program: $12,447.11 (up from $11,206.28 in 2023).

The Online Disclosure to CMS Form must be submitted to CMS annually, and upon any change that affects whether the drug coverage is creditable:

  • Within 60 days after the beginning date of the plan year
  • Within 30 days after the termination of the prescription drug plan
  • Within 30 days after any change in the creditable coverage status of the prescription drug plan

 

 

This information has been prepared for UBA by Fisher & Phillips LLP. It is general information and provided for educational purposes only. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.

Recent Insights

May 19, 2023
Webinar

Webinar: Navigate Your Way Through FMLA

Tuesday, June 13, 2023 1 – 2PM CST Register Now Attend this month’s webinar to learn how to recognize if you are a covered employer, which employees are eligible, and qualifying reasons for Family and Medical Leave (FMLA). Gain insights into: Regulations surrounding mental health and substance abuse leave Managing benefits during FMLA leave Coordination […]
Read more
May 17, 2023
News

April 2023 Compliance Recap

READ TIME: 4 MINUTES While the compliance focus for April continues to be on the Prescription Drug Data Collection (RxDC) of the Consolidated Appropriations Act, 2021, the Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D. 2024 Benefit Parameters for Medicare Part D Creditable […]
Read more
May 17, 2023
News

Update on the End of the COVID-19 National Emergency and Public Health Emergency

READ TIME: 5 MINUTES In January 2023, the Biden administration announced its intent to end the COVID-19 national emergency and the COVID-19 public health emergency effective May 11, 2023, directly impacting the coverage of certain COVID-19 services as well as the timeframes for participants for certain health plan-related deadlines, such as special enrollment, COBRA election, […]
Read more
April 26, 2023
News

DOL Signals July 10 as End of COVID-19 Outbreak Period, Despite Early End to National Emergency

READ TIME: 6 MINUTES On Monday, April 10, 2023, President Biden signed Congress’s jointly-introduced H.J Res. 7 into law, ending the COVID-19 National Emergency immediately instead of on May 11, 2023, as previously announced. However, the Department of Labor (DOL) has unofficially signaled that its previous guidance issued on March 29, 2023, stands, including guidance […]
Read more