LICS copay level discrepancy
This is a discussion on LICS copay level discrepancy within the Managed Care Pharmacy Administrative Issues forum, part of the Managed Care Drug Coverage category; One of our users posed a question, specific to Medicare Part D: When the PDE file does not match the ...
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06-04-2008, 03:02 PM
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LICS copay level discrepancy
One of our users posed a question, specific to Medicare Part D:
When the PDE file does not match the correct copay level for a low-income subsidy (LICS) member, what is the optimal approach to ensuring correct adjudication? Before the PDE is updated, should a plan adjust prescription claims for that member on a case-by-case basis? Or should a plan simply wait until a correction has been made to the PDE file? How are different plans interpreting/handling this issue? 
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