Wednesday, November 16, 2011 | Kenneth A. Mason
Filed under:
Medicare, Health Plans
A federal appeals court has held that the Medicare Secondary Payer (“MSP”) Act authorizes a medical provider to sue an employer health plan for
double damages when the plan fails to comply with the MSP Act, thereby forcing the provider to accept the lower level of reimbursement available under Medicare. This Sixth Circuit decision, in
Bio-Medical Applications of Tennessee, Inc. v. Central States Southeast and Southwest Areas Health and Welfare Fund, definitely
raises the stakes for health plans that fail to comply with the MSP rules.
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Monday, May 16, 2011 | Chadron Patton
Filed under:
Medicare, Health Care Reform, Health Plans
On April 1, 2011, the Centers for Medicare and Medicaid Services ("CMS") issued revised Medicare Part D creditable and non-creditable coverage notices to reflect an amendment made to the Social Security Act by the Affordable Care Act ("ACA"). The amendment accelerated the Medicare Part D annual enrollment period — from November 15 through December 31, to October 15 through December 7. This change is effective for 2012 Part D enrollments, occurring in the fall of 2011.
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Friday, November 20, 2009 | Kenneth A. Mason
Filed under:
Medicare, Dollar Limits, Qualified Retirement Plans
Traditionally, the IRS has announced inflation-adjusted retirement plan limits in October, based on the inflation rate during the prior twelve-month period. This time, however, the IRS announcement was that these limits would not be decreased, despite an actual rate of deflation during the prior twelve months. Accordingly, virtually all of the dollar amounts under which retirement plans have been administered during 2009 will remain the same for 2010.
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Wednesday, November 26, 2008 | David Stevens
Filed under:
Medicare, Health Plans
Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 adds a new mandatory reporting requirement for group health plans. The overall purpose of this program is to make sure that Medicare pays benefits secondary to any applicable private health care coverage. The Centers for Medicare and Medicaid Services (“CMS”) is responsible for this program, and has recently announced information about how the program will be implemented.
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Monday, September 01, 2008 | Julia M. Vander Weele
Filed under:
Medicare, Health Plans, Reporting and Disclosure
The Medicare Part D regulations issued by the Centers for Medicare and Medicaid Services (“CMS”) require group health plans providing prescription drug coverage to Part D-eligible individuals to disclose to participants whether the coverage is “creditable” — that is, at least as good as Medicare Part D coverage. Plans must send these notices to participants each fall, prior to the beginning of the initial enrollment period for Medicare Part D coverage.
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Sunday, July 01, 2007 | Julia M. Vander Weele
Filed under:
Medicare, Discrimination, Health Plans
After protracted litigation, the Third U.S. Circuit Court of Appeals has finally upheld regulations issued by the Equal Employment Opportunity Commission (“EEOC”) allowing employers to reduce, change, or even eliminate retiree health coverage when retirees become eligible for Medicare. Unless this decision is reversed by the U.S. Supreme Court (which seems unlikely), employers who coordinate, terminate, or charge different premiums for retiree health coverage upon a retiree’s Medicare eligibility should be able to retain such practices without fear of violating the Age Discrimination in Employment Act (“ADEA”).
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Monday, May 01, 2006 | Julia M. Vander Weele
Filed under:
Medicare, Health Plans, Reporting and Disclosure
As we reported in our July 2005 issue of Benefits in Brief, the Medicare Part D regulations issued by the Centers for Medicare and Medicaid Services (“CMS”) require group health plans providing prescription drug coverage to Part D-eligible individuals to disclose to participants whether that coverage is “creditable” – that is, at least as good as Medicare Part D coverage. Most plans sent these notices to participants last fall, prior to the beginning of the initial enrollment period for Medicare Part D coverage.
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Wednesday, February 01, 2006 | Julia M. Vander Weele
Filed under:
Medicare, Health Plans, Reporting and Disclosure
As we reported in our July 2005 issue of Benefits in Brief, regulations issued by the Centers for Medicare and Medicaid Services (“CMS”) require group health plans providing prescription drug coverage to Medicare Part D-eligible individuals to disclose to participants whether that coverage is “creditable.” Plan sponsors were required to send these notices by November 15, 2005. CMS has now released guidance regarding the plan sponsor’s obligation to disclose information regarding the plan’s creditable coverage status to CMS.
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