For what types of health benefit items and services can a sponsor receive reimbursement?
A sponsor can receive reimbursement for health benefit items and services for which Medicare would reimburse under Parts A, B, and D. For general reference as to what items and services are covered by Medicare Parts A and B, please refer to the Centers for Medicare & Medicaid Services’ (CMS) Medicare & You 2010 and Your Medicare Benefits publications, which are available on the Medicare.gov website. For information on certain items and services that are excluded from Medicare Parts A and B, see the HHS guidance document Claims Eligible for Reimbursement Under the Early Retiree Reinsurance Program. Click here for a detailed listing of procedure codes that ERRP will not credit towards the cost threshold or reimburse. Generally, to determine whether a given drug is a Part D drug, ERRP plan sponsors should first review the regulatory definition of a Part D drug found at 42 CFR ยง423.100. ERRP plan sponsors may also wish to review the relevant provisions of Chapter 6 of the Medicare Part D M
