Don’t Overlook Prescription Drug Reporting to CMS - Bim Group

Don’t Overlook Prescription Drug Reporting to CMS


Each year, a bright light is cast on providing individuals with annual Medicare Part D notices detailing the creditable status of their employer-provided prescription drug coverage. Lurking in the shadows is another annual requirement: reporting to the Centers for Medicare & Medicaid Services (CMS) whether the prescription drug coverage is creditable or not. These tips will help employers better understand this lesser[1]known Medicare Part D compliance obligation.


Plan sponsors must input their disclosures to CMS every year, no later than 60 days following the start of a new plan year. Thus, calendar year plan sponsors must report their plans’ creditable status by March 1. Plan sponsors also must alert CMS within 30 days after terminating the prescription drug plan or coverage, or if the creditable status changes.


Plan sponsors must use CMS’s creditable coverage portal to complete and file the necessary creditable coverage disclosure form. CMS offers no paper alternative to satisfy this disclosure requirement absent one of a few rare and limited exceptions. The good news is that the CMS portal includes helpful hyperlinks to agency guidance and simple step-by-step instructions.


It is easy to forget creditable coverage reporting during the hectic ACA and W-2 reporting season. Also, HR professionals tend to be swamped with participant inquiries at the outset of a new plan year, so it can be easy to miss a basic compliance obligation like creditable coverage reporting. Plan sponsors with calendar year plans should set a reminder each year to ensure they complete this task by March 1

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

February 26, 2024
Compliance Alert, HHS

HHS Releases Updated Drug Data Collection Reporting Instructions in Advance of June 1, 2024, Deadline

Under Section 204 of the Consolidated Appropriations Act, 2021 (CAA), referred to as “The No Surprises Act” (NSA), all employer-sponsored health plans must satisfy certain transparency requirements by reporting annual prescription drug and health care spending data (often referred to as the Prescription Drug Data Collection (RxDC) report). The RxDC report is not only about […]
Read more
February 26, 2024
Compliance Alert

January 2024 Compliance Recap

READ TIME: 7 MINUTES January was a relatively quiet month on the employee benefits compliance front. The Wage and Hour Division of the Department of Labor (DOL) introduced a new rule laying out the guidelines employers can follow to determine how to classify workers. The DOL also released Part 64 of its FAQs about Affordable […]
Read more
January 31, 2024

2024 Employer-Sponsored Group Health Plans Compliance Calendar

Employers and HR departments are faced with many reporting and notification requirements for their employer-sponsored group health plans. Information must be provided to plan participants and applicable government agencies on time to ensure compliance with various federal laws. This compliance calendar outlines the requirements and due dates for: Form W-2 Form 5500 Forms 1094-B and […]
Read more
January 11, 2024

The Play-or-Pay Penalty and Counting Employees under the ACA

Since 2015, the Affordable Care Act (ACA) has required applicable large employers (ALEs) to offer their full-time employees health coverage or pay one of two shared responsibility penalties (ESRP or “play-or-pay”). An employer is an ALE if it employs 50 or more full-time or full-time equivalent employees. Final IRS regulations provide guidance to help employers […]
Read more