A provision in last year’s federal health reform law accelerated Medicare Part D’s annual enrollment period, beginning this year. The annual enrollment period used to run from November 15 to December 31; however, for this year and future years, the annual enrollment period is October 15 to December 7. This change suggests that health plans might need to supply to enrollees a revised Medicare Part D notice – showing the new Part D annual enrollment period – prior to October 15.
Health plans have been required to supply their enrollees with a special notice, the Medicare Part D notice, to help enrollees covered by Medicare identify whether their health plan’s prescription drug coverage is “creditable”, or at least as good as Medicare Part D, and make informed and timely decisions about whether and when to enroll in Medicare Part D to avoid a late enrollment penalty. These notices must be provided prior to the Medicare Part D annual enrollment period each year.
Existing guidance from Medicare with respect to these notices says that a once given by a health plan, the Part D notice need not be provided again during the ensuing 12 months, unless the creditable or non-creditable nature of the plan’s drug benefit changes. Many plans simply included them in their annual enrollment packets. But because of delays in the issuance by federal regulators of updated, model Medicare Part D notices, the accelerated Part D enrollment period was not reflected in many plans’ Part D notices supplied to their enrollees late in 2010 (for open enrollment for the 2011 year). When CMS issued revised model notices earlier this spring, it did not specify whether plans that provided notices reflecting the prior annual enrollment period are required to issue an updated notice prior to October 15.
So what are plan sponsors supposed to do now? Absent formal guidance from CMS, the conservative approach is to distribute the new Part D notice prior to October 15, either separately or in open enrollment packets for 2012, if the packets will be issued that early. Alternatively, plan sponsors may choose to wait and distribute the updated Part D notice after October 15, but include it in open enrollment packets distributed prior to December 7. For non-creditable plans that choose not to distribute the updated notice at all this year, the potential consequences appear to be fairly minimal. Currently, CMS does not appear to impose penalties for failure to timely distribute Part D notices to enrollees. In addition, an enrollee who misses out on the Part D annual enrollment period due to inaccurate notices from the plan sponsor, and winds up paying a late enrollment penalty, may apply to CMS for a waiver of the late enrollment period.