Medicare program managers could make life a little easier in 2027 for employers that offer health savings accounts, health reimbursement arrangements or individual coverage health reimbursement arrangement plans.
Officials want to exempt the sponsors from having to tell health plan participants who are ages 65 or older whether they have solid prescription drug coverage.
The Centers for Medicare and Medicaid Services, the federal agency that oversees Medicare, put that provision in a new set of draft Medicare plan regulations for 2027 that was posted Tuesday.
The provision would eliminate the need for employers to send “notice of creditable coverage” forms to the people in their health plans cover who appear to be eligible for Medicare.
The 465-page packet is the first set of general contract-year Medicare plan regulations prepared during the current administration of President Donald Trump.
Comments on the draft regulations are due Jan. 26, 2026.
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What will this mean for administrators of HSA and other plans?
What it means: CMS officials estimated that the change could help cut prescription drug coverage analysis costs and notice costs for the administrators of 7,049 HSA, HRA and ICHRA plans.
The provision could also be a sign that CMS will try to cut the paperwork requirements associated with the Affordable Care Act.
Medicare Part D plans: Medicare is a program that provides coverage for 69 million people who are ages 65 or older, are disabled or suffer from severe kidney disease.
Many Medicare enrollees have Medicare Advantage plans, or comprehensive health plans, that include both Medicare medical benefits and Medicare prescription drug benefits.
Another 24 million Medicare enrollees buy Medicare Part D stand-alone drug plans.
Medicare Part D creditable coverage: CMS tries to manage the flow of Medicare Part D program claim risk by encouraging relatively young, healthy Medicare enrollees to sign up for drug plans and begin paying premiums as soon as they lose access to other prescription drug coverage, such as employer-sponsored prescription drug benefits.
A Medicare enrollee who signs up for drug plan coverage late may have to pay a late enrollment penalty.
An employer that provides prescription drug benefits is supposed to send any covered workers, dependents and retirees who are ages 65 or older notices stating whether the prescription benefits are rich enough to be “creditable coverage,” according to the CMS creditable coverage website.
Plan participants with creditable coverage can put off signing up for Medicare Part D plans without having to worry about late enrollment penalties.
Participants who have relatively low-value employer-sponsored prescription drug benefits may have to start paying for Part D coverage early, even while the low-value employer plan is in place, to avoid having to pay late enrollment penalties.
CMS officials said they want to exempt ICHRA plans and other health account plans from the creditable coverage notice requirements because the plans don’t provide coverage that’s equivalent to traditional prescription drug plan coverage, and because the users of health accounts usually get prescription drug coverage from a traditional health coverage provider.
Other CMS Medicare draft regulation provisions: Other parts of the new draft Medicare regulations for 2027 could:
- Add a depression screening item to the Medicare plan Star quality rating program.
- Add Novo Nordisk’s semaglutide products and 14 other drugs to the list of drugs that are part of Medicare’s prescription drug price negotiation program.
- Update the rules governing “third-party marketing organizations,” or Medicare plan marketers, distributors and sellers.
CMS hopes to help TPMOs by easing consumer call recording requirements; making it easier for agents to meet individually with consumers after educational seminars or other events; and starting to apply different rules to different types of TPMOs, such as brick-and-mortar agencies, national marketers and field marketing organizations.
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