How are rebates calculated in the arc formula?
How are rebates calculated in the arc formula?
The computation of ARC requires the subtraction of rebates and similar price concessions (“rebates”). The following discusses how, for purposes of reporting cost data, a sponsor’s actual rebates can be allocated among unique benefit options, by month, as opposed to allocating rebates on a drug-specific basis for each retiree.
How are rebates calculated on an interim basis?
Under 42 CFR §423.888(b), a sponsor may elect to receive subsidy payments from CMS on an interim or annual basis. If the sponsor elects an interim basis, it must submit with its interim cost data estimated rebates based on historical data and generally accepted actuarial principles (except as otherwise provided by CMS).
When do sponsors have to submit rebate information?
If the sponsor elects an interim basis, it must submit with its interim cost data estimated rebates based on historical data and generally accepted actuarial principles (except as otherwise provided by CMS). The sponsor also must submit actual rebate information within 15 months after the end of the plan year as part of the reconciliation process.
Under 42 CFR §423.888(b), a sponsor may elect to receive subsidy payments from CMS on an interim or annual basis. If the sponsor elects an interim basis, it must submit with its interim cost data estimated rebates based on historical data and generally accepted actuarial principles (except as otherwise provided by CMS).
The computation of ARC requires the subtraction of rebates and similar price concessions (“rebates”). The following discusses how, for purposes of reporting cost data, a sponsor’s actual rebates can be allocated among unique benefit options, by month, as opposed to allocating rebates on a drug-specific basis for each retiree.
If the sponsor elects an interim basis, it must submit with its interim cost data estimated rebates based on historical data and generally accepted actuarial principles (except as otherwise provided by CMS). The sponsor also must submit actual rebate information within 15 months after the end of the plan year as part of the reconciliation process.