What is Best Available Evidence?
The Centers for Medicaid and Medicare Services (CMS) created the Best Available Evidence (BAE) policy in 2006 for Part D plans that administer the Low-Income Subsidy (LIS) program, including the reduction of cost sharing for subsidy-eligible individuals.
This policy requires plans to accept certain forms of documentation for a beneficiary’s eligibility for LIS, to change the beneficiary’s cost-sharing levels in the plans system based on that documentation, and for LIS beneficiaries to submit to CMS requests for correction of the data in their system if the changes do not occur as a result of routine State reporting.
Click on the following link to obtain more information about Best Available Evidence (Please note that by clicking on this link, you will leave Kalos Health’s website).
Questions? Call our Member Services Department at 1-800-399-1954 (TTY: 711), Monday through Friday 8am – 8pm.
Kalos Health Gold Plus is a Health Maintenance Organization (HMO) Special Needs Plan (SNP) with a Medicare contract and a coordination of benefits agreement with the New York State Department of Health. Enrollment in Kalos Health Gold Plus depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits may change on January 1 of each year. You must continue to pay your Medicare Part B premium (unless your part B premium is paid for you by Medicaid or another third party).
Last Updated 12-12-2017