Weekly Health Compliance Briefing

April 15, 2026

Note to Subscribers

 

While we do our best to provide timely updates, it is possible that the information shared in the newsletter may change after our publication deadline.

Health Notes

 

Final Regulation Exempts HRAs From Medicare Part D Creditable Coverage Reporting
On April 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final regulation that removes the requirement for account-based plans, including Health Reimbursement Arrangements (HRAs), to report creditable coverage status to individuals eligible for Medicare Part D prescription drug coverage and to the CMS.

The Social Security Act requires entities offering prescription drug coverage (including group health plans) to provide notice to Medicare Part D-eligible individuals and to the CMS regarding whether the coverage equals or exceeds the actuarial value of standard prescription drug coverage under Medicare Part D. Account-based health plans, including HRAs, have been required to report and provide notice. 

In general, the actuarial value of prescription drug coverage generally can be expressed as the percentage of the total average costs for covered Part D drugs for which a group health plan will pay. HRAs, in contrast, are accounts funded solely by an individual’s employer to reimburse the medical expenses of employees, their spouses, and their dependents. The financial benefit of HRAs is difficult to compare against the actuarial value of a prescription drug plan. Accordingly, under the prior notice requirements, individuals could receive contradictory notices (such as a non-creditable coverage notice from an HRA and a creditable coverage notice from a prescription drug plan) leading to confusion about whether individuals were actually enrolled in creditable coverage. 

The final regulation exempts only account-based plans (HRAs, including Individual Coverage HRAs, as well as health Flexible Spending Accounts and Health Savings Accounts) from the creditable coverage disclosure requirements in 2027. Group health plans that provide prescription drug coverage are still required to comply with these disclosure requirements.

Aon Publications

 

New Coding for Maternity Care to Take Effect in 2027
Starting in 2027, the common procedural terminology codes for maternity care will change from a bundled global maternity code to multiple itemized codes reflecting individual services. As a result of this change, group health plans will no longer be billed a bundled payment for maternity care. Instead, each individual item and service will be billed separately. The coding change may impact plan costs, participant cost-sharing, access, and care. Employer plan sponsors should talk with their carriers and/or claims administrators to understand how this change may impact maternity care services for their group health plans. 

The Aon bulletin is available here.