Tag Archives: RDS

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

2019 Medicare Part D benefit parameters published
The Centers for Medicare & Medicaid Services (CMS) released the Medicare Part D standard benefit parameters and the cost thresholds and limits for qualified retiree prescription drug plans for 2019.

For more information, click here.

CMS’ RDS Center now accepting Medicare Beneficiary Identifier (MBI) in retirees files
Effective as of April 1, 2018, the CMS’ Retiree Drug Subsidy Center is accepting Medicare Beneficiary Identifier (MBI) in retiree files. Plan Sponsors and Vendors should take note that the use of MBI is not mandatory within the RDS Program and that RDS will continue to accept SSN and/or HICN or RRB indefinitely. For information on the use of MBI in RDS retiree file formats please reference the following pages in the RDS User Guide:

• Retiree File Layouts
• Retiree Response File Layouts
• Weekly Notification File Layouts
• Covered Retiree List File Layout and Format
• RDS Reason Codes

For more information, contact CMS’ RDS Center.

The importance of evaluating RDS and EGWP trends to optimize plan value

Financial dynamics and an evolving regulatory environment in the group retiree pharmacy benefits market continue to influence the relative values of Employer Group Waiver Plans (EGWPs) and Retiree Drug Subsidy (RDS) plans. Plan sponsors should periodically monitor and evaluate emerging trends in these programs to optimize plan value in this still-changing market.

Last summer, for example, the Centers for Medicare and Medicaid Services (CMS) announced a large decrease in the monthly direct subsidy revenue to EGWPs. Additionally, the Medicare Payment Advisory Commission (MedPAC) recently proposed changes to the Medicare program with major implications for EGWP costs.

Figure 1 summarizes key recent and proposed market and regulatory dynamics that are already impacting the relative values of EGWPs and RDS plans—and which could potentially influence further shifts in these values.

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