StacksVerified U.S. regulatory reference

42 CFR §423.2516

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
  1. (a)Appointment by CMS. CMS appoints a Part D sponsor that meets the requirements at § 423.2512 to serve as the LI NET sponsor.
  2. (b)Selection criteria. In appointing a LI NET sponsor, CMS evaluates the following:
    1. (1)Experience covering low-income beneficiaries, including but not limited to enrolling and providing coverage to low-income subsidy individuals as defined in § 423.34;
    2. (2)Pharmacy access as outlined in § 423.120;
    3. (3)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
    4. (4)Ability to meet the requirements listed in § 423.505 that are not waived under § 423.2536.
  3. (c)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.