Beginning with costs incurred in January 2024, the Centers for Medicare & Medicaid Services (CMS) Retiree Drug Subsidy (RDS) Program will implement an update to the program’s sequestration policy, whereby the mandatory payment reduction will be applied at each interim payment request and the Reconciliation final payment request.
The RDS Program is subject to the mandatory reductions in federal spending, or sequestration, in accordance with the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA), as amended. Beginning with plan sponsors' incurred costs reported on or after April 1, 2013, and for the duration of the sequestration period, CMS applies a mandatory payment reduction to all plan months when calculating an RDS application's final Reconciliation subsidy payment.
This new change only affects Plan Sponsors who choose to submit interim payment requests. Plan Sponsors who submit only one annual payment request during Reconciliation will not be affected by this change because sequestration is already applied to those requests and will continue to be applied to them in the future. Refer to the Announcement Important Enhancement to RDS Payment Frequency on the RDS Public Website for more information on payment frequency.
Refer to Changes to the Suspension of Sequestration for the Retiree Drug Subsidy Program Take Effect on July 1, 2022 for a reminder about previous updates to the sequestration policy.
If you have questions about the mandatory payment reduction or need additional information, please contact CMS' RDS Center.
Thank you for your continued participation in the RDS Program.