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There are no specific penalties for employers that fail to comply with the Medicare Part D disclosure requirements, except for employers that are claiming the Retiree Drug Subsidy. However, by not providing creditable coverage disclosure notices, employers may trigger adverse employee relations issues.
A Certificate of Creditable Coverage may be obtained from your former health insurance carrier. Please contact your previous health carrier and request them to provide you with a certificate. This certificate may partially or fully apply to your new coverage and alleviate pre-existing situations.
A person will usually receive a Notice of Creditable Coverage in the mail every September, and they should keep this as proof should they later apply for Medicare coverage. If a person wishes to enroll in Medicare after their creditable coverage ends, they may be eligible for the Special Enrollment Period.
Group health plan sponsors that provide prescription drug coverage to anyone eligible for Medicare Part D coveragesuch as employees age 65 or oldermust annually disclose to the federal Centers for Medicare Medicaid Services (CMS) whether that coverage is actuarially equivalent to Medicare Part D prescription drug
You can call your insurance customer service department at any point during your coverage and ask for a written copy of your certificate of coverage. This should be provided free of charge. This document explains the health benefits you and your dependents have under the plan.
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Why Is CMS Compliance Important? Facilities providing care to Medicare and Medicaid patients must follow all CMS regulations to avoid any legal and financial penalties. CMS administers several different programs for these facilities, so the specific type of penalty that can be incurred will depend on the situation.
Who is responsible for sending out creditable coverage notices? In general, entities that offer prescription drug coverage on a group basis to active and retired employees and beneficiaries who are Medicare eligible individuals.

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