Early Retiree Reinsurance Program to deny reimbursement for claims incurred after 2011
The Centers for Medicare & Medicaid Services (“CMS”) announced on December 6, 2011 that based on the projected availability of funding under the Early Retiree Reinsurance Program (ERRP), CMS is exercising its authority to deny certain reimbursement requests. The Patient Protection and Affordable Care Act (PPACA) created the ERRP, which provides reimbursement to eligible sponsors of employment-based plans for a portion of the costs of providing health coverage to early retirees. The regulations further provide that based on the projected or actual availability of funding, CMS may deny applications that otherwise meet the ERRP requirements. The Notice provides that CMS is exercising this power, and will deny ERRP reimbursement requests, in their entirety, that include claims which were incurred after December 31, 2011. The regulations provide that a plan sponsor may only submit a claim for reimbursement after it has been incurred and paid. Pursuant to the Notice, and current CMS policy, a plan sponsor may still submit a claim for reimbursement for claims incurred before December 31, 2011, but paid after December 31, 2011. For more information on the ERRP, please contact your Trust Fund counsel.
Author: Ezekiel D. Carder
