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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
Clever Care Health Plan, Inc. is an HMO and HMO C-SNP with a Medicare contract. Enrollment depends on contract renewal.
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