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I started getting phone calls from my clients this last Sunday. I got 10 more calls on Monday. The insurance carriers are sending out letters, not to everyone but to those they can't verify for sure that they had credible coverage on their MAPD or PDP plans for 2006 and 2007.
What is happening is that CMS is beginning to review when a member was eligible for their PDP or MAPD to determine if the Late Enrollment Penalty (LEP) should apply. While CMS talked about applying it they never actually did. Now they are beginning to look at people and asking for creditable coverage if necessary. CMS has asked all carries to begin a audit period and forward the information to CMS so they can determine if an LEP will be applied to the member or not.
What is happening is that CMS is beginning to review when a member was eligible for their PDP or MAPD to determine if the Late Enrollment Penalty (LEP) should apply. While CMS talked about applying it they never actually did. Now they are beginning to look at people and asking for creditable coverage if necessary. CMS has asked all carries to begin a audit period and forward the information to CMS so they can determine if an LEP will be applied to the member or not.