Best Available Evidence (BAE) Policy

CMS created the “best available evidence” policy in 2006 requiring plans to establish the appropriate cost-sharing for low-income beneficiaries when presented with evidence that the beneficiary’s information was not accurate.

CMS continues to require Part D plans to rely on best available evidence and considers it best practice for the Part D plans to work with pharmacies to resolve these issues at point-of-sale when beneficiaries present with appropriate evidence of correct low-income status.

For more information call Customer Service or visit the CMS website