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US · guidance

CMS Pub. 100-16, ch. 7, § 70.4.2

Low Income Status

activein force · 2026-08-25 – presentas-observed

From 2006 through 2010, the Part D risk adjustment model used a multiplier to adjust

risk scores when the beneficiary had low income subsidy eligibility. Under the 2006-

2010 RxHCC model, the multiplier differed if the beneficiary was full subsidy eligible or

partial subsidy eligible. Starting in 2011, the Part D risk adjustment model no longer

uses multipliers and instead uses a separate risk score for beneficiaries who have low

income status. This new model applies an aged low income or disabled low income risk

score when the beneficiary has either full or partial low income status and does not have

long term institutional status. Low income status is determined as of the payment month.

History

(Rev. 114, Issued; 06-07-13, Effective: 06- 07-13, Implementation: 06-07-13)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
ba26da9b45603fb57868f532f2c5639432854950df93ecac7ab41e4bf9bd71a5
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