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Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

Key Implementation Dates for the Medicare Prescription Drug Benefit

This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit. Some of these dates are defined in the MMA statute, while others are from the final rule issued by the Centers for Medicare and Medicaid Services.

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Date

Implementation Activity

January 1 –

March 31, 2005

Low-income beneficiaries enrolling in Medicare drug discount card program this quarter receive full-year $600 subsidy for 2005 (subsidy pro-rated for part-year enrollment for remainder of 2005)

January 2005

CMS launches “awareness” phase of message campaign for drug benefit

February 18, 2005

Deadline for “Notice of Intent to Apply” from standalone PDPs, new MA contractors, and regional PPOs

March 2005

CMS issues guidance for employers on retiree creditable coverage

March 1, 2005

Deadline for current MA contractors to submit a request for a special needs plan

March 15, 2005

SSA pilot mailing of low-income subsidy applications to 2,050 beneficiaries in 42 zip codes

March 23, 2005

Deadline for PDPs, MA-PDs, and cost contractors to submit Part D applications

March 23, 2005

Deadline for “Notice of Intent to Apply” from employers or unions directly contracting as a PDP or MA-PD

March 28 – April 18, 2005

CMS accepts CY 2006 formularies from PDPs and MA-PDs

April 2005

Information on low-income subsidy eligibility published on Medicare.gov

April 4, 2005

CMS announces MA capitation rates, MA local area benchmarks and adjustment factors for 2006

April 18, 2005

Deadline for employers to submit PDP or MA-PD applications

April 30, 2005

CMS releases letter with 2006 enrollment and payment instructions and releases instructions to states on how to process state eligibility determinations

May 31, 2005

CMS begins sending mailings to low-income subsidy-eligible beneficiaries and dual eligibles

June 1, 2005

Deadline for CMS to approve PDP plan applications and MA service area expansions

June 6, 2005

Deadline for submitting PDP and MA-PD bids to CMS

June 6, 2005

Deadline for employers to submit formularies to CMS

June 20 – 30, 2005

CMS mails informational letter to dual eligibles regarding transition to Medicare plans

June 30, 2005

CMS distributes CY 2006 summary of benefits instructions to MA contractors

June 31, 2005

Deadline for CMS to pre-qualify bidders from eligible fallback entities for plans starting in 2006

July 2005

CMS launches “discussion” phase of message campaign

July 1, 2005

Medicaid and SSA begin processing applications for low-income subsidies

July 1, 2005

Deadline for CMS to establish requirements and procedures for coordination between Part D plans and SPAPs and other insurers (Medicaid, group health plans, FEHBP, TRICARE)

August 3, 2005

CMS releases national average monthly bid amount and calls for reallocation of rebates for MA-PDs (if needed)

August 3 –

September 30, 2005

CMS accepts retiree drug subsidy applications from employers and unions

August 2005SSA begins sending decisions to those who applied for low-income subsidies

September 14, 2005 (tentative)

CMS approves bids for PDPs and MA-PDs

September 15, 2005PDP and MA-PD contracts signed

September 16 –

November 15, 2005

Medigap issuers send written disclosures to policyholders with drug coverage informing them of their options

September 30, 2005

Deadline for plan sponsors to submit to CMS attestation of actuarial equivalence

September 30, 2005

Deadline for plan sponsors to apply for retiree drug subsidy payment for 2006

October 1, 2005

Approved Part D plans begin marketing

October 1, 2005

Deadline for transfer of Medicare appeals from SSA to DHHS

October 13, 2005

CMS begins disseminating information comparing available Part D coverage to beneficiaries via mail with the Medicare & You handbook, 1-800-MEDICARE, and Plan Comparison Web Tool and Medicare Personal Plan Finder on Medicare.gov

October 15, 2005

Deadline for Secretary to notify states of their annual per capita drug payment amounts (“clawback”) for 2006

October 21, 2005

CMS announces decision on retiree drug subsidy applications

October 27 –

November 10, 2005

CMS mails auto-enrollment information to dual eligibles

November 15, 2005 –
May 15, 2006

Coordinated election period for 2006 Part D enrollment for all beneficiaries

November 15, 2005 –

May 15, 2006

States and entities offering drug coverage provide written disclosure to Part D eligible individuals regarding actuarial equivalence

December 31, 2005

Medicaid drug coverage ends for full benefit dual eligibles

December 31, 2005

Medicare drug discount card program ends

January 1, 2006

  • Part D coverage begins for all beneficiaries enrolled in a plan

  • Dual eligibles' auto-enrollment takes effect

  • Low-income subsidies for Part D coverage begin

  • Medigap insurers prohibited from selling new policies with drug coverage

January 1, 2006 –

December 2007

Moratorium on formation of new local Medicare PPOs

January 1 – June 30, 2006

Open enrollment period for MA-eligible individuals (during which they can change plans once)

January 1 – June 30, 2006

CMS launches “urgency” phase of message campaign

February 25, 2005States begin making monthly “clawback” payments to federal government for dual eligibles

February 28, 2006

Retiree drug subsidy payments begin

March 2006

CMS identifies all beneficiaries not enrolled in a Medicare prescription drug plan

April 2006

CMS mails spring enrollment reminder to beneficiaries

April – May 2006CMS facilitates enrollment in a prescription drug plan for those determined to be eligible for low-income subsidies but have not yet enrolled in a planMay 15, 2006

End of coordinated election period for 2006 Part D enrollment

June 1, 2006Coverage begins for low-income subsidy eligible beneficiaries who were assigned to a prescription drug plan by CMS

October 15, 2006

Deadline for Secretary to notify states of their annual per capita drug payment amounts (“clawback”) for 2007

November 15, 2006

States and entities offering drug coverage provide written disclosures to Part D eligible individuals regarding actuarial equivalence

November 15 –

December 31, 2006

Annual coordinated election period for 2007 Part D enrollment for all beneficiaries

Timeline last updated: June 8, 2005