§423.2516. Selection of LI NET sponsor and contracting provisions.
42 C.F.R. § 423.2516
Appointment by CMS. CMS appoints a Part D sponsor that meets the requirements at § 423.2512 to serve as the LI NET sponsor.
Selection criteria. In appointing a LI NET sponsor, CMS evaluates the following:
Experience covering low-income beneficiaries, including but not limited to enrolling and providing coverage to low-income subsidy individuals as defined in § 423.34;
Pharmacy access as outlined in § 423.120;
Past performance, including Star Ratings (as detailed in § 423.186), previous intermediate sanctions (as detailed in § 423.750), and consistent with past performance in § 423.503(b); and
Ability to meet the requirements listed in § 423.505 that are not waived under § 423.2536.
Term of appointment. The term of the appointment will be ongoing provided mutual agreement between CMS and the selected party, subject to an annual contracting and bid process (per § 423.2524(b)) to determine payment rates for the upcoming year.
Notes, amendments, and revision history
Source
Source: 88 FR 22342, Apr. 12, 2023, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302, 1306, 1395w-101 through 1395w-152, and 1395hh.
Source
Source: 70 FR 4525, Jan. 28, 2005, unless otherwise noted.