During this webinar the Direct Contracting Model Options team hosted a webinar on Wednesday, December 18, 2019 from 1:30 p.m.- 3:00 p.m. EST. During this webinar, presenters provided information about benefit enhancements for the Direct Contracting Model Options.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Tuesday, February 11, 2014 from 2:30 – 4:30pm EST that provided an overview of the demonstration and the application package.
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CMS Innovation Center
http://innovation.cms.gov
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During this webinar the Direct Contracting Model Options team hosted a webinar on Wednesday, December 11, 2019 from 1:30pm-3:00 p.m. EST entitled, Direct Contracting Overview/Direct Contracting Entity (DCE) Types/Alignment. During this webinar, presenters provided an overview of the Direct Contracting Model Professional and Global Options, including information about the participation and eligibility requirements, Direct Contracting Entity (DCE) types, payment mechanisms, and beneficiary alignment methodology.
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CMS Innovation Center
http://innovation.cms.gov
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During this webinar the Primary Care First Model Options team provided an introduction to the Primary Care First Model that is geared towards payers, presented and answered questions live on topics related to payer partnership, including the Primary Care First payer alignment framework, benefits of multi-payer partnership, and the payer solicitation elements and selection process.
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CMS Innovation Center
http://innovation.cms.gov
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The Million Hearts: Cardiovascular Disease Risk Reduction Model team hosted an open door forum on Thursday, September 3, 2015. Attendees received an overview of the application as well an opportunity for question and answers about the Model. Joining the team was Paul Meissner, Director of Research Program Development at Montefiore Medical Center, who talked about why the Model is important to his organization.
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CMS Innovation Center
http://innovation.cms.gov
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The Primary Care First Model Options team hosted a payment webinar on Thursday, June 27, 2019 from Noon - 1:00 p.m. EDT. Topics discussed included what the Primary Care First Total Primary Care Payment and the quality measures used to calculate the Performance-Based Adjustment, beneficiary attribution, policies on overlap with other CMS models, and the timeline for receiving model payments.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Monday, March 3, 2014 to provide information on how to calculate budget neutrality for the five prongs in the Frontier Community Health Integration Project Demonstration. CMS also provided examples of ways that applicants can respond to the solicitation. Subject matter experts from the CMS Innovation Center and the Health Resources Services Administration (HRSA) provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
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The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care First (KCF) Model Option introduction webinar on Friday, November 15, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted the first of two webinars on November 19 to describe the final rule and respond to questions about the Comprehensive Care for Joint Replacement Model.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted a webinar on Tuesday, February 11, 2014 from 2:30 – 4:30pm EST that provided an overview of the demonstration and the application package.
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CMS Innovation Center
http://innovation.cms.gov
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CMS Privacy Policy
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During this webinar the Direct Contracting Model Options team hosted a webinar on Wednesday, December 11, 2019 from 1:30pm-3:00 p.m. EST entitled, Direct Contracting Overview/Direct Contracting Entity (DCE) Types/Alignment. During this webinar, presenters provided an overview of the Direct Contracting Model Professional and Global Options, including information about the participation and eligibility requirements, Direct Contracting Entity (DCE) types, payment mechanisms, and beneficiary alignment methodology.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
During this webinar the Primary Care First Model Options team provided an introduction to the Primary Care First Model that is geared towards payers, presented and answered questions live on topics related to payer partnership, including the Primary Care First payer alignment framework, benefits of multi-payer partnership, and the payer solicitation elements and selection process.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Million Hearts: Cardiovascular Disease Risk Reduction Model team hosted an open door forum on Thursday, September 3, 2015. Attendees received an overview of the application as well an opportunity for question and answers about the Model. Joining the team was Paul Meissner, Director of Research Program Development at Montefiore Medical Center, who talked about why the Model is important to his organization.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Primary Care First Model Options team hosted a payment webinar on Thursday, June 27, 2019 from Noon - 1:00 p.m. EDT. Topics discussed included what the Primary Care First Total Primary Care Payment and the quality measures used to calculate the Performance-Based Adjustment, beneficiary attribution, policies on overlap with other CMS models, and the timeline for receiving model payments.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted a webinar on Monday, March 3, 2014 to provide information on how to calculate budget neutrality for the five prongs in the Frontier Community Health Integration Project Demonstration. CMS also provided examples of ways that applicants can respond to the solicitation. Subject matter experts from the CMS Innovation Center and the Health Resources Services Administration (HRSA) provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care First (KCF) Model Option introduction webinar on Friday, November 15, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted the first of two webinars on November 19 to describe the final rule and respond to questions about the Comprehensive Care for Joint Replacement Model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum covering benefit enhancements for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, April 19 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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The CMS Innovation Center held the fourth in a series of webinar events for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Wednesday, June 29, 2016 from 4:00p.m. – 5:00p.m. EDT. This webinar explored the LDO and non-LDO financial methodologies and the quality measures that are part of this model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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This was the second event in a two-part webinar series on the Primary Care First Seriously Ill Population (SIP) payment model option. During this webinar, the Primary Care First Model Options team reviewed additional details about the SIP payment model option. This webinar built upon what was discussed during the first SIP webinar held on July 24, 2019 and provided an opportunity for attendees to submit live questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The Next Generation ACO Model team hosted an open door forum on Tuesday, March 28, 2017. The Next Generation Model features three payment rule waivers, referred to as benefit enhancements. This open door forum provided an overview of the Model’s three benefit enhancements.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing a application overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum washeld on Tuesday, March 29 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum covering financial methodology for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, April 5 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
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The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care Contracting (CKCC) Model Options finance webinar on Friday, November 22, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the third in a series of open door forums on March 31, 2015 focusing on financial methodology and related issues.
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CMS Innovation Center
http://innovation.cms.gov
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On Tuesday, April 9 from 2:00 p.m. - 3:00 p.m. EDT the Medicare Advantage Value-Based Insurance Design Model team provided an overview of the model’s main goals and guiding principles, provided a brief review of Medicare Advantage and the Medicare Hospice Benefit, introduced the key model design considerations, and provided a general timeline for the coming months.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Emergency Triage, Treat, and Transport (ET3) Model team hosted an overview webinar about the ET3 Model Request for Applications (RFA) on Tuesday, June 11 from 2:00 - 3:00 p.m. EDT. The ET3 Model team reviewed key components of the RFA, including eligibility requirements, necessary information required to submit a complete application, and application timelines.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
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During this webinar the Part D Senior Savings Model team provided an overview of the insulin model and discussed the Request for Applications (RFAs).
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the first in a series of open door forums focusing on various aspects of the Model.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the fourth in a series of open door forums on Tuesday, April 7, 2015. This open door forum focused on benefit enhancements and beneficiary care coordination reward.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted an introduction webinar about the Oncology Care Model (OCM) on Thursday, February 19, 2015 from 12:00pm – 1:00pm EST. The webinar focused on introducing core concepts of OCM and application instructions. Advance registration was not required.
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CMS Innovation Center
http://innovation.cms.gov
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The Integrated Care for Kids (InCK) Model team presented a webinar covering the notice of funding opportunity application on Thursday, April 18 from 2:30 p.m. to 4:00 p.m. EST.
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CMS Innovation Center
http://innovation.cms.gov
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In this July 18, 2012 webinar CMS Innovation Center staff discussed how applicants can apply and prepare their budget for the Strong Start funding opportunity.
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CMS Innovation Center
http://innovation.cms.gov
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This open door forum provided follow up information to 2014 Shared Savings Program ACOs applying to AIM, including suggestions and resources to consider when submitting their application. Attendees had the opportunity to ask subject matter experts questions about the AIM application process.
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CMS Innovation Center
http://innovation.cms.gov
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In this Thursday, July 12, 2012 webinar, presentations focused on learning more about program requirements, preferences, and other keys to success from CMS Innovation Center staff and communities currently participating in the CCTP program. The final CCTP review panel for 2012 convened on September 20, 2012. Applications must have been received by September 3rd to be considered for this review. Future panels may be announced as funding permits.
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CMS Innovation Center
http://innovation.cms.gov
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The CMS Innovation Center hosted an informational webinar March 11, 2014 on the parameters of Models 2-4 of the Bundled Payments for Care Improvement Initiative. This webinar was geared towards physicians, specialty practices and physician group practices.
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CMS Innovation Center
http://innovation.cms.gov
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The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum covering benefit enhancements for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, April 19 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The CMS Innovation Center held the fourth in a series of webinar events for the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Model on Wednesday, June 29, 2016 from 4:00p.m. – 5:00p.m. EDT. This webinar explored the LDO and non-LDO financial methodologies and the quality measures that are part of this model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This was the second event in a two-part webinar series on the Primary Care First Seriously Ill Population (SIP) payment model option. During this webinar, the Primary Care First Model Options team reviewed additional details about the SIP payment model option. This webinar built upon what was discussed during the first SIP webinar held on July 24, 2019 and provided an opportunity for attendees to submit live questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Next Generation ACO Model team hosted an open door forum on Tuesday, March 28, 2017. The Next Generation Model features three payment rule waivers, referred to as benefit enhancements. This open door forum provided an overview of the Model’s three benefit enhancements.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum providing a application overview for the 2017 Next Generation Accountable Care Organization Model. The open door forum washeld on Tuesday, March 29 from 4:00pm – 5:30pm EDT.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) hosted an open door forum covering financial methodology for the 2017 Next Generation Accountable Care Organization Model. The open door forum was held on Tuesday, April 5 from 4:00pm – 5:30pm EDT.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care Contracting (CKCC) Model Options finance webinar on Friday, November 22, 2019 from 12:00 p.m. - 1:00 p.m. EST.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the third in a series of open door forums on March 31, 2015 focusing on financial methodology and related issues.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
On Tuesday, April 9 from 2:00 p.m. - 3:00 p.m. EDT the Medicare Advantage Value-Based Insurance Design Model team provided an overview of the model’s main goals and guiding principles, provided a brief review of Medicare Advantage and the Medicare Hospice Benefit, introduced the key model design considerations, and provided a general timeline for the coming months.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Emergency Triage, Treat, and Transport (ET3) Model team hosted an overview webinar about the ET3 Model Request for Applications (RFA) on Tuesday, June 11 from 2:00 - 3:00 p.m. EDT. The ET3 Model team reviewed key components of the RFA, including eligibility requirements, necessary information required to submit a complete application, and application timelines.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted a webinar on Wednesday April 9, 2014 to provide an overview of the Medicare Care Choices Model and the application process. Subject matter experts from the CMS Innovation Center provided details and answered questions.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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During this webinar the Part D Senior Savings Model team provided an overview of the insulin model and discussed the Request for Applications (RFAs).
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the first in a series of open door forums focusing on various aspects of the Model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the fourth in a series of open door forums on Tuesday, April 7, 2015. This open door forum focused on benefit enhancements and beneficiary care coordination reward.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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The Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted an introduction webinar about the Oncology Care Model (OCM) on Thursday, February 19, 2015 from 12:00pm – 1:00pm EST. The webinar focused on introducing core concepts of OCM and application instructions. Advance registration was not required.
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The Integrated Care for Kids (InCK) Model team presented a webinar covering the notice of funding opportunity application on Thursday, April 18 from 2:30 p.m. to 4:00 p.m. EST.
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In this July 18, 2012 webinar CMS Innovation Center staff discussed how applicants can apply and prepare their budget for the Strong Start funding opportunity.
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This open door forum provided follow up information to 2014 Shared Savings Program ACOs applying to AIM, including suggestions and resources to consider when submitting their application. Attendees had the opportunity to ask subject matter experts questions about the AIM application process.
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In this Thursday, July 12, 2012 webinar, presentations focused on learning more about program requirements, preferences, and other keys to success from CMS Innovation Center staff and communities currently participating in the CCTP program. The final CCTP review panel for 2012 convened on September 20, 2012. Applications must have been received by September 3rd to be considered for this review. Future panels may be announced as funding permits.
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The CMS Innovation Center hosted an informational webinar March 11, 2014 on the parameters of Models 2-4 of the Bundled Payments for Care Improvement Initiative. This webinar was geared towards physicians, specialty practices and physician group practices.
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This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
The Kidney Care Choices (KCC) Model team hosted a Comprehensive Kidney Care Contracting (CKCC) Model Options introduction webinar on Tuesday, November 12, 2019 from 12:00 p.m. - 1:00 p.m. EST.
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The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
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Due to popular demand, the Comprehensive Primary Care Plus (CPC+) team hosted a repeat of the webinar that was originally held on Wednesday, April 27, 2016. During this webinar Model team members provided an overview of the model specifically for interested payers.
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The Value-Based Insurance Design (VBID) Model team hosted a webinar on January 28, 2021 from 4:00-5:00 PM EST. During this webinar, presenters provided a brief review of the recently released Calendar Year (CY) 2022 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component. This session also offered attendees an opportunity to ask follow-up questions.
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State RegulationsDeidra ManningHMGT 310University of.docxdessiechisomjj4
State Regulations
Deidra Manning
HMGT 310
University of Maryland
Professor Jerome Bozek
November 29, 2015
Student Name:
Deidra Manning
Assignment #3 Title:
Selection of a state regulation; The unannotated South Carolina Code of Regulations
Agency Responsible:
The South Carolina Legislative Council; The State Health and Human Services Finance Commission through the MEDICAID
Incentives and Enforcement:
The main enforcements are observed through ensuring that only the service providers enrolled in the program are the ones which provide the services, therefore enrollment is controlled and regulated Clients must be eligible for Medicaid to receive the services. The residents of South Carolina recipients of the services can be referred outside the South Carolina area, when this happens, they must have a prior approval from a state agency administering the Medicaid Program.
Technical assistance for the personnel providing the services is contained in the South Carolina State Plan for Title XIX (Medicaid), provider manuals, Medicaid Bulletins, and federal directives. This gives directives on their usage serving as a guide to their usage.
Key Aspect of the Regulation #1:
This regulation: 126-304 Community Long Term Care Home and Community Based Services.
It sets out clearly the requirements of the service receiver who should be a Medicaid eligible person, eighteen years of age or older, who has been determined by community long term care to require a skilled or intermediate level of care.this regulation has an effect on health care proffssional since they are required meet the said conditions.
(2) Home delivered meals are the in home provision of at least one meal per day to persons unable to care for their nutritional needs. This has a financial implication to the provider institution and making transport arrangements on availing the meals to the homes of the recipients.
(3) Medical day care is a group of services to restore, maintain and promote the health status through the provision of ambulatory health care and health related supportive services in a licensed medical day care center. This group of services requires that systems be put in place to receive alerts of emergence and a response team which shall be on standby to attend to the emergencies as and when they arise.
Medical social services are supportive services provided by an individual with no less than a Masters Degree in social work. The legal of academical training is essential to the personnel providing this service, because it is specific to the academical requirement of the said personnel
Personal care is the in home provision of the necessary services in support of activities of daily living, home support, medical monitoring, and client transportation services to restore, maintain and promote health status. This specifically affects the provider institution because special arrangements have to made to ensure adequate trained personnel to adequately manage the home provisio.
Attorney Michael James spoke to Michigan Association of CPAs yesterday on his presentation "Accountable Care Organizations 2.0". The presentation addressed the hundreds of pages of recently proposed regulations related to ACOs that represent the most dramatic overhaul of the Medicare Shared Savings Program since its inception. Other insights in the presentation:
- Current Regulatory Environment for Integrated Models
- How Environment Evolves Under Proposed Regulations
- Various Requirements Needed for ACOs
- Potential Risks Under Current ACO Models
To learn more, contact attorney Michael James at mjames@fraserlawfirm.com or 517-377-0823. Michael James is a senior attorney at Fraser Trebilcock, providing representation and counseling related to all facets of business enterprise and health care matters.
NOTE: Information contained in this presentation is only current as of the blog publish date. For updated information, refer to the Fraser Trebilcock Health Care Reform blog: fraserlawfirm.com
What Physicians Need to Know: CMS Final Rules 2024Conference Panel
The CMS proposed rule for physician payment and coding changes sets the tone for the upcoming year. Attending this update ensures you are well-informed about the latest regulatory changes affecting healthcare services. Understanding the modifications proposed by CMS allows providers to adapt their coding practices, ensuring accurate reimbursement for the services they provide.
Knowledge of issues that were not implemented for 2023 provides valuable insights into what CMS is considering for the following year. This foresight enables strategic planning for 2024, allowing healthcare professionals to anticipate and prepare for potential changes. This year's update promises significant changes to key areas such as EM services, splits/shared care, remote patient monitoring (RPM), and complex chronic care management (CCM).
Register,
https://conferencepanel.com/conference/cms-physician-final-rules-for-2024-find-out-what-cms-has-finalized-from-the-proposed-rules
The Center for Medicare and Medicaid Innovation hosted a series of two webinars on Wednesday, July 15 and Thursday, July 16, 2015. These webinars focused on providing an overview of the model and provided an opportunity for attendees to ask questions.
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The Direct Contracting Model Options team hosted a webinar on January 15, 2020 to provide an overview of the Direct Contracting Model's payment methodology. During the session, the Direct Contracting model team presented key aspects of the Direct Contracting financial model, such as its risk-sharing options and risk mitigation strategies, as well as its capitation and other advanced payment alternatives. The forum also provided an opportunity for potential applicants to ask the team questions regarding these topics and other topics related to the model application.
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Similar to Webinar: Direct Contracting Model Options - Benefit Enhancements (20)
The Medicare Advantage Value-Based Insurance Design (VBID) Model team at the Center for Medicare and Medicaid Innovation (CMMI) and national leaders participated in a discussion around pathways for addressing food and nutritional insecurity at webinar event of our Health Equity Incubation Program on Thursday, March 31, 2022, from 3:00-4:30 PM ET.
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The CMS Innovation Center hosted an office hours session on Tuesday, April 5, 2022 from 3:00-4:00 PM ET to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees received an overview of the Model and the CY 2023 application process, and had an opportunity for questions and answers with the Model team.
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The ACO REACH Model Team will hosted a health equity webinar on Tuesday, April 5, 2022 from 4:00 - 5:00 p.m. EDT. The ACO REACH Model team highlighted Health Equity provisions added to the ACO REACH Model.
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This webinar focuses on the new financial policies featured in the ACO REACH webinar. For more information on the financial methodology for the ACO REACH Model that will be transitioned from the Global and Professional Direct Contracting (GPDC) Model, please refer to prior released financial webinars available on the GPDC Model webpage.
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During this webinar, a high-level overview of the ACO REACH Model was provided including information on the participation and eligibility requirements, Accountable Care Organization (ACO) types, payment mechanisms, and beneficiary alignment methodology.
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The CMS Innovation Center will host a webinar on Thursday, March 10, 2022 from 3:00-4:00 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.
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This webinar provided an overview of the Model and the Part D Sponsor application process, as well as included a Q&A session for interested Part D sponsors.
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The CMS Innovation Center hosted a webinar on Wednesday, March 2, 2022 at 3pm – 4pm ET, during which presenters shared updates on the Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model, the Kidney Care Choices (KCC) Model, and the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This event was available to the first 1,000 registrants. Presentation materials will be available on the respective model webpages following the session.
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The Medicare Advantage Value-Based Insurance Design (VBID) Model Team hosted an office hours session on Thursday February 3rd, 2022 on the Hospice Benefit Component to provide technical and operational support to interested stakeholders. During this office hours session, presenters answered questions submitted in advance to the VBID Mailbox and offered attendees an opportunity to ask additional questions.
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Has your organization prioritized addressing health inequities? How can a Center for Medicare and Medicaid Innovation (CMMI) Model factor into your organization’s health equity strategy? How can you structure your plan’s benefits to have the greatest impact on underserved communities? What partnership opportunities are available with CMMI?
These are important questions CMMI plans to answer in a new webinar series focused on health equity! CMMI is sponsoring a series of webinars for current and potential Medicare Advantage Organization (MAO) participants in the Value-Based Insurance Design (VBID) Model.
The first webinar in the series provided an overview of the Model’s Health Equity Incubation Sessions effort, articulated a business case for MAOs to leverage VBID Model Components to address health inequities in their member populations, and provided specific guidance and clarification on the full extent of health equity focused flexibilities that fall under the Model’s waiver authority.
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CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
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As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
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The ET3 Model and Medicaid: Opportunities for Alignment webinar provided background on the ET3 Model, discussed the benefits for states of aligning coverage and payment policies with ET3, and explored considerations for states seeking to implement new Medicaid services that align with the ET3 Model. This webinar was intended for state Medicaid agencies, ET3 Model Participants, and other stakeholders interested in learning more about optional Medicaid alignment with the ET3 Model.
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CMS announced an Office Hour event for potential applicants to ask questions ahead of the PCF application deadline.
The PCF Model Team was available to answer questions on key topics including eligibility, payment design and attribution, and more.
You may also refer to the materials from the two PCF webinars held in March: Introduction to PCF and Ready, Set, Apply.
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In order to help ETC Model Participants prepare for the ETC Model, CMS conducted an introductory webinar on Wednesday, December 9, 2020 from 1 p.m. to 2 p.m. The webinar provided an overview of the ETC Model, including:
Participant selection
The Home Dialysis Payment Adjustment
The Performance Payment Adjustment
The ETC Model timeline, including the timing of payment adjustments
Information about how to communicate with CMS about the ETC Model
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The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Wednesday, March 17, 2021 from 4:00 - 5:00 PM EDT. During this webinar, presenters provided a preview of the Calendar Year 2022 payment design related to the Hospice Benefit Component of the VBID Model. The session also offered attendees an opportunity to ask follow-up questions.
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The Part D Senior Savings Model and Part D Payment Modernization Model teams hosted a webinar on Tuesday, March 23, 2021 from 1:00 to 2:00 PM EDT. During this webinar, presenters provided an overview of the two Models and the Calendar Year (CY) 2022 application process. The session also offered attendees an opportunity to ask follow-up questions.
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CMS hosted a virtual office hour session on April 13, 2021 from 4:00-5:00 PM EDT. During this office hour, presenters provided a review of the Calendar Year 2022 payment design and payment rates related to the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. This session also offered attendees an opportunity to ask follow-up questions.
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The Primary Care First Model (PCF) Options team provided an overview of the PCF payer partnership. Participants were able to learn about current PCF Model participants, benefits to payer partnership, the framework against which payer proposal alignment will be evaluated, and the payer solicitation process and timeline.
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The Primary Care First Model Options team provided an overview of the Model, including goals, eligibility to participate in the second cohort, payment design and attribution, and data sharing. Model staff answered your questions about these topics.
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More from Centers for Medicare & Medicaid Services (CMS) (20)
A process server is a authorized person for delivering legal documents, such as summons, complaints, subpoenas, and other court papers, to peoples involved in legal proceedings.
Many ways to support street children.pptxSERUDS INDIA
By raising awareness, providing support, advocating for change, and offering assistance to children in need, individuals can play a crucial role in improving the lives of street children and helping them realize their full potential
Donate Us
https://serudsindia.org/how-individuals-can-support-street-children-in-india/
#donatefororphan, #donateforhomelesschildren, #childeducation, #ngochildeducation, #donateforeducation, #donationforchildeducation, #sponsorforpoorchild, #sponsororphanage #sponsororphanchild, #donation, #education, #charity, #educationforchild, #seruds, #kurnool, #joyhome
Up the Ratios Bylaws - a Comprehensive Process of Our Organizationuptheratios
Up the Ratios is a non-profit organization dedicated to bridging the gap in STEM education for underprivileged students by providing free, high-quality learning opportunities in robotics and other STEM fields. Our mission is to empower the next generation of innovators, thinkers, and problem-solvers by offering a range of educational programs that foster curiosity, creativity, and critical thinking.
At Up the Ratios, we believe that every student, regardless of their socio-economic background, should have access to the tools and knowledge needed to succeed in today's technology-driven world. To achieve this, we host a variety of free classes, workshops, summer camps, and live lectures tailored to students from underserved communities. Our programs are designed to be engaging and hands-on, allowing students to explore the exciting world of robotics and STEM through practical, real-world applications.
Our free classes cover fundamental concepts in robotics, coding, and engineering, providing students with a strong foundation in these critical areas. Through our interactive workshops, students can dive deeper into specific topics, working on projects that challenge them to apply what they've learned and think creatively. Our summer camps offer an immersive experience where students can collaborate on larger projects, develop their teamwork skills, and gain confidence in their abilities.
In addition to our local programs, Up the Ratios is committed to making a global impact. We take donations of new and gently used robotics parts, which we then distribute to students and educational institutions in other countries. These donations help ensure that young learners worldwide have the resources they need to explore and excel in STEM fields. By supporting education in this way, we aim to nurture a global community of future leaders and innovators.
Our live lectures feature guest speakers from various STEM disciplines, including engineers, scientists, and industry professionals who share their knowledge and experiences with our students. These lectures provide valuable insights into potential career paths and inspire students to pursue their passions in STEM.
Up the Ratios relies on the generosity of donors and volunteers to continue our work. Contributions of time, expertise, and financial support are crucial to sustaining our programs and expanding our reach. Whether you're an individual passionate about education, a professional in the STEM field, or a company looking to give back to the community, there are many ways to get involved and make a difference.
We are proud of the positive impact we've had on the lives of countless students, many of whom have gone on to pursue higher education and careers in STEM. By providing these young minds with the tools and opportunities they need to succeed, we are not only changing their futures but also contributing to the advancement of technology and innovation on a broader scale.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Presentation by Jared Jageler, David Adler, Noelia Duchovny, and Evan Herrnstadt, analysts in CBO’s Microeconomic Studies and Health Analysis Divisions, at the Association of Environmental and Resource Economists Summer Conference.
Canadian Immigration Tracker March 2024 - Key SlidesAndrew Griffith
Highlights
Permanent Residents decrease along with percentage of TR2PR decline to 52 percent of all Permanent Residents.
March asylum claim data not issued as of May 27 (unusually late). Irregular arrivals remain very small.
Study permit applications experiencing sharp decrease as a result of announced caps over 50 percent compared to February.
Citizenship numbers remain stable.
Slide 3 has the overall numbers and change.
Russian anarchist and anti-war movement in the third year of full-scale warAntti Rautiainen
Anarchist group ANA Regensburg hosted my online-presentation on 16th of May 2024, in which I discussed tactics of anti-war activism in Russia, and reasons why the anti-war movement has not been able to make an impact to change the course of events yet. Cases of anarchists repressed for anti-war activities are presented, as well as strategies of support for political prisoners, and modest successes in supporting their struggles.
Thumbnail picture is by MediaZona, you may read their report on anti-war arson attacks in Russia here: https://en.zona.media/article/2022/10/13/burn-map
Links:
Autonomous Action
http://Avtonom.org
Anarchist Black Cross Moscow
http://Avtonom.org/abc
Solidarity Zone
https://t.me/solidarity_zone
Memorial
https://memopzk.org/, https://t.me/pzk_memorial
OVD-Info
https://en.ovdinfo.org/antiwar-ovd-info-guide
RosUznik
https://rosuznik.org/
Uznik Online
http://uznikonline.tilda.ws/
Russian Reader
https://therussianreader.com/
ABC Irkutsk
https://abc38.noblogs.org/
Send mail to prisoners from abroad:
http://Prisonmail.online
YouTube: https://youtu.be/c5nSOdU48O8
Spotify: https://podcasters.spotify.com/pod/show/libertarianlifecoach/episodes/Russian-anarchist-and-anti-war-movement-in-the-third-year-of-full-scale-war-e2k8ai4
Russian anarchist and anti-war movement in the third year of full-scale war
Webinar: Direct Contracting Model Options - Benefit Enhancements
1. Direct Contracting:
Professional and Global Options
Benefit Enhancements and Patient Engagement
Incentives
December 18, 2019
Center for Medicare and Medicaid Innovation
Centers for Medicare & Medicaid Services (CMS)
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3. Agenda
1 Background and Overview
2 Current Benefit Enhancements Tested Under the Innovation Center
3 Current Patient Engagement Incentives Tested Under the Innovation Center
4 Newly Proposed Benefit Enhancements for Performance Year One
5 Possible Future Benefit Enhancements and Patient Engagement Incentives
The benefit enhancements and patient engagement incentives described in this webinar are proposed
and subject to change. CMS will release more information as it becomes available.
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4. Audience Poll
Is your organization eligible to participate in the Direct Contracting model?
a) Yes
b) No
c) Unsure
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6. 6
Background of Direct Contracting
• Direct Contracting Model (Direct Contracting), together with the Primary Care First
Model and the updated Medicare Shared Savings Program ENHANCED Track, are
part of the CMS strategy to use the redesign of primary care to drive broader
delivery system reform to improve health and reduce costs.
• The model builds off the Next Generation Accountable Care Organization (ACO)
Model and innovations from Medicare Advantage and private sector risk sharing
arrangements.
Lowerrisk
Higherrisk
Primary Care First
Medicare Shared
Savings
ENHANCED Track
Direct Contracting
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Direct Contracting | Center for Medicare & Medicaid Innovation
7. Model Goals and Approach
The information below represents Direct Contracting model goals and how CMS expects to achieve
these goals.
Transform
risk-sharing
arrangements
• Flexible cash flows
• Predictable, prospective spending targets
• Payment that recognizes the challenges of caring for complex chronically ill
populations
Empower
and engage
beneficiaries
• Enhanced voluntary alignment
• Various benefit enhancements and patient engagement incentives
Reduce
provider
burden
• Small set of core quality measures
• Waivers to facilitate care delivery
• Opportunities for organizations new to Medicare FFS to participate
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8. Benefit Enhancement and Patient Engagement
Incentives
CMS is seeking to emphasize high-value services and support the ability of DCEs to manage the
care of beneficiaries through benefit enhancements and patient engagement incentives.
DCEs may choose which, if any, of these benefit enhancements and
patient engagement incentives to implement.
Applicants must provide information regarding the implementation of
selected benefit enhancements and patient engagement incentives
in their applications.
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9. Building on the Next Generation ACO Model
Direct Contracting proposes to offer the same benefit enhancements and patient engagement
incentives available in the Next Generation ACO model as well as three newly proposed benefit
enhancements.
Currently in Next Generation ACO
Model
Newly Proposed for Performance Year
1 of Direct Contracting
1. Telehealth Expansion Benefit 1. Home Health Services Certified by
Nurse PractitionersEnhancement
2. Post-Discharge Home Visits Benefit 2. Homebound Requirement Waiver for
Home HealthEnhancement
3. Care Management Home Visits 3. Concurrent Care for Beneficiaries that
Benefit Enhancement Elect the Medicare Hospice Benefit
4. 3-Day SNF Rule Waiver Benefit
Enhancement
5. Chronic Disease Management Reward
6. Cost Sharing Support for Part B
Services
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11. Benefit Enhancements
Benefit Enhancements are conditional waivers of certain Medicare payment rules. CMS uses the
authority under Section 1115A of the Social Security Act (Section 3021 of the Affordable Care Act) to
conditionally waive certain Medicare payment requirements.
Goals of these benefit enhancements are to:
Emphasize high-
value services
Support care
management and
closer care
relationships
Allow DCE
flexibility
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12. Telehealth Expansion
Overview
• This waiver will:
Eliminate the rural geographic component of
originating site requirements,
Allow the originating site to include a
beneficiary’s home, and
Permit the use of asynchronous telehealth
services in the specialties of
teledermatology and teleophthalmology
provided that certain requirements are met.
• An aligned beneficiary will be eligible for the
Telehealth Expansion Waiver if the
beneficiary is located at their home or one of
the CMS) defined telehealth originating sites.
• Asynchronous ("store and forward")
telehealth ophthalmology and dermatology
services includes transmission of recorded
health history through a secure electronic
communications system to a practitioner who
uses the information to evaluate the case, or
render a service outside of a real-time
interaction.
Implementation
Waiver will apply to both new and existing
beneficiaries aligned to a Direct Contracting
Entity.
• Distant site practitioners will bill for these new
services using Innovation Center specific
asynchronous telehealth codes.
• Distant site practitioner must be a DC
Participant Provider or Preferred Provider who
has elected to use this benefit enhancement,
and beneficiaries must be aligned to a DCE
that has selected this benefit enhancement.
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13. Post-Discharge Home Visits
Overview
• Physicians (or other practitioners)* can
currently provide certain post-discharge
services in patients' homes
o This is not a home health (or homebound)
service
• Under existing regulations, this service must be
provided under direct physician supervision
(i.e., physician/other practitioner is present at
time service is provided to patient)
• Under the Post-Discharge Home Visits Benefit
Enhancement, the service may be provided
under general supervision—physician (or
other practitioner) may contract with auxiliary
personnel to provide this service and the
service is billed by the physician’s (or other
practitioner’s) office
o Provides flexibility during this critical time
post-discharge for patients
Implementation
• Auxiliary personnel (as that term is defined
under 42 CFR 410.26(a)(1)) under the general
– instead of direct – supervision of a DC
Participant Provider or Preferred Provider (i.e.,
physician or other practitioner) may furnish
"incident to" services at an aligned
beneficiary’s home.
• Up to a total of nine post-discharge visits may
be furnished within 90 days following discharge
from an inpatient facility (e.g., hospital, CAH,
SNF, IRF).
• DCEs are required to abide by their state’s
laws regarding the provision of incident to
services.
*Note: When the post-discharge home visit waiver and physician are referred to together, we are also including “or other
practitioner” as eligible to bill for services furnished “incident to” their own services per 42 C.F.R. § 410.26(b)(5)
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14. Care Management Home Visits
Overview
• Care Management Home Visits are home
visits that can be provided by auxiliary
personnel (as that term is defined under 42
CFR 410.26(a)(1)) under the general
supervision of a DC Participant Provider or
Preferred Provider who has initiated a care
treatment plan for an aligned beneficiary.
• This benefit enhancement provides flexibility in
billing for home visits provided to beneficiaries
to prevent possible hospitalization
o Eliminates requirement that these services
be furnished under direct supervision.
• Beneficiaries who are eligible or currently in a
home health episode are not eligible for Care
Management Home Visits; it is not a home
health service.
Implementation
• A beneficiary will be eligible to receive up to 12
Care Management Home Visits within a
performance year.
• Care Management Home Visit services are
considered to be "incident to" services
currently allowable through Medicare.
o DC Participant Providers and Preferred
Providers should follow the Medicare
documentation rules surrounding
"incident to" services.
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15. Care Management Home Visits: Beneficiary
Eligibility
Beneficiary is at risk of hospitalization;
Beneficiary does not qualify for Medicare coverage of home health services
(unless living in a medically underserved area is the sole basis for qualification);
Services are furnished in home after DC Participant Provider or Preferred
Provider has initiated a care treatment plan; and
Beneficiary is not receiving services under the Post-discharge Home Visits
benefit enhancement.
This benefit enhancement is available for aligned beneficiaries
under the following circumstances:
1
2
3
4
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16. 3-Day SNF Rule Waiver: Overview
The 3-day SNF Rule Waiver conditionally waives the requirement of a 3-day inpatient stay prior to
SNF (or swing-bed hospital) admission.
Beneficiaries must meet the clinical
criteria for admission.
• E.g., beneficiary must be medically stable
with confirmed diagnosis and identified
skilled nursing or rehabilitation need.
SNF must have overall quality rating of three or
more stars in 7 out of the past 12 months under the
CMS 5-Star Quality Rating System.
• Star ratings are reviewed at the time the Proposed DC
Participant Provider list or Preferred Provider list is
submitted.
SNF must be listed on the Proposed DC
Participant Provider list or Preferred Provider
List with the SNF benefit enhancement indicated.
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17. 3-Day SNF Rule Waiver: Beneficiary Eligibility
1 Beneficiary is not residing in a SNF or long-term care facility at the time of SNF
admission under this waiver.
• For purposes of this waiver, independent living facilities and assisted living facilities shall not be
deemed long-term care facilities.
2
3
Beneficiary is medically stable and has confirmed diagnoses.
Beneficiary has skilled nursing or rehabilitation need identified by a physician or other
practitioner that cannot be provided on an outpatient basis.
• For direct admission, beneficiary has an evaluation within 3 days prior to SNF
admission by a physician or another practitioner licensed to perform the evaluation.
• For direct admission, the beneficiary does not require inpatient hospital evaluation or
treatment.
• For admission following fewer than 3 days of inpatient hospitalization, beneficiary
does not require further inpatient hospital evaluation or treatment.
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19. Chronic Disease Management Reward
This patient engagement incentive allows DCEs to provide gift cards (annual limit of $75) to eligible
beneficiaries to incentivize participation in a chronic disease management program.
In order to participate, an eligible beneficiary must have a clinically diagnosed chronic disease targeted by a
qualifying Chronic Disease Management Program in the DCE’s Implementation Plan
A gift card may be provided under the Chronic Disease Management Reward Program
benefit enhancement only if:
Beneficiary was an eligible beneficiary at time enrolled in, or began participating in, the Chronic
Disease Management Program.
Beneficiary satisfied all criteria for obtaining gift card, as set forth in the DCE’s Implementation Plan.
Gift card is provided to the beneficiary directly by the DCE.
Cost of the gift card is funded entirely by the DCE.
Gift card is programmed to prevent the purchase of tobacco and/or alcohol products.
The gift card cannot be offered in the form of cash or monetary discounts or rebates,
including reduced cost-sharing or reduced premiums and cannot be redeemable for cash.
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20. Qualifying Chronic Disease Management Programs
A Chronic Disease Management Program is a program described in the DCE’s Implementation Plan
that focuses on promoting improved health, preventing injuries and illness, and promoting efficient
use of health care resources for individuals with the chronic diseases targeted by the program.
For example, a Chronic Disease Management Program may include:
Utilizing particular services or preventive screening benefits
Adhering to prescribed treatment regimens
Attending education or self-care management lessons, and
Meeting nutritional goals
A survey alone does not constitute a Chronic Disease Management Program.
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21. Cost Sharing Support for Part B Services
This patient engagement incentive allows the DCE to enter into arrangements with DC Participant
Providers and Preferred Providers under which the DC Participant Providers and Preferred Providers
would reduce or eliminate beneficiary cost sharing amounts (in whole or in part) for categories of aligned
beneficiaries and for categories of Part B services identified by the DCE.
• DCEs will make payments to those DC Participant Providers and Preferred Providers
to cover some or all of the amount of beneficiary cost sharing not collected.
• The goal of offering this cost sharing support is to reduce financial barriers so that
certain beneficiaries may obtain needed care and better comply with treatment plans,
thereby improving their own health outcomes.
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22. Cost Sharing Support for Part B Services
(Continued)
Eligible Services may include any Part B service identified in the DCE’s
Implementation Plan, which must not include durable medical equipment or
prescription drugs.
Eligible Beneficiaries may include, without limitation, one or more of the following:
• Aligned Beneficiaries without Medicare supplemental insurance (i.e., Medigap),
• Aligned Beneficiaries experiencing high health care costs, and/or
• Aligned Beneficiaries who require certain Part B services, the receipt of which could
reduce the individual’s overall health care costs.
The Cost Sharing Support must advance one or more of the following clinical goals:
• Adherence to a treatment regime,
• Adherence to a drug regime,
• Adherence to a follow-up care plan, or
• Management of a chronic disease or condition.
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23. Cost Sharing Arrangement
The DCE must have an agreement with each DC Participant Provider and
Preferred Provider who has agreed to provide Cost Sharing Support for
Part B Services and must specify the following:
Categories of eligible beneficiaries and eligible services where they may
provide Cost Sharing Support;
Requirement that the DC Participant Provider or Preferred Provider provide
Cost Sharing Support in accordance with the DCE’s Implementation Plan;
and
Amount and frequency with which DCE will reimburse DC Participant
Provider or Preferred Provider for the cost sharing amounts not collected.
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24. Audience Poll
How likely are you to apply to participate in the Direct Contracting model?
a) Very likely
b) Likely
c) Unlikely
d) Very unlikely
e) Unsure
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26. .
Home Health Services Certified by Nurse
Practitioners
Current Requirements
Under current Medicare rules, nurse
practitioners can order home health services,
but Medicare will not pay for those services
unless a physician certifies a beneficiary’s
eligibility for the home health benefit.
As a result, nurse practitioners must locate
a physician to document the nurse
practitioner’s assessment, even though the
physician is not necessarily involved in the
assessment.
For example, a beneficiary who lacks access
to a primary care physician and is instead
under the care of a nurse practitioner may first
be admitted to a facility and placed under the
care of a facility-based physician before home
health services can be ordered.
CMS would allow Nurse Practitioners that are
DC Participant Providers or Preferred
Providers to certify home health benefit
eligibility for aligned beneficiaries.
• Provides a streamlined approach
to certifying home health patients and
avoiding duplicative work;
• Reduces impediments that hinder
care coordination and transition of
care for patients; and
• Is consistent with CMS’ aim of
allowing greater use of non-physician
practitioners and supporting existing
patient-provider relationships
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Proposed Waiver
27. Home Health Services Certified by Nurse Practitioners:
Implementation
Under this waiver, DCEs may allow nurse practitioners to certify that aligned
beneficiaries are eligible to receive the home health benefits in accordance with
Section 1814(a)(2)(C) of the Act and 42 CFR §424.22(a)(1).
However, this waiver would only apply for DCEs in those states that allow nurse
practitioners to order home health care for beneficiaries within their scope of
practice.
Medicare would continue to assume costs for these home health services.
o This waiver would broaden the category of medical personnel that can
certify home health care services for aligned beneficiaries.
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28. Homebound Requirement Waiver for Home Health
Current Requirements Proposed Waiver
A beneficiary must be confined to the home
("homebound") as defined in § 1814(a) and §
1835(a) in order for Medicare to cover and
pay for home health services.
This requirement can limit access to home
health services, as it focuses on a
beneficiary’s mobility limitations rather than
the underlying health conditions or
comorbidities often present in this population.
The proposed waiver of this rule would:
• Permit Medicare reimbursement of
home health services for
beneficiaries with certain clinical
risk factors that are not
homebound.
• Enhance patients’ ability to return
to, remain in, and receive care in
their home.
Providing access to home health services is
expected to reduce hospital readmissions,
improve patient outcomes, and reduce costs
for this population.
This additional flexibility also would aid DCEs
in developing alternative payment
arrangements with home health agencies,
promoting innovation.
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29. Homebound Requirement Waiver for Home Health:
Eligibility
CMS proposes aligned beneficiaries would be eligible for this conditional
waiver if they:
1
2
Otherwise qualify for home health services under 42 C.F.R. § 409.42 except
that the beneficiary is not required to be confined to the home; and
Have a combination of clinical risks, which will be determined by CMS at a
later date.
Beneficiaries that are receiving services under the post-discharge visits or care
management home visits benefit enhancements would not be eligible to receive
covered home health services under this benefit enhancement.
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30. Homebound Requirement Waiver for Home Health:
Implementation
DCEs would identify home health providers that are DC Participant Providers or
Preferred Providers to provide these services to eligible aligned beneficiaries.
All other requirements regarding Medicare coverage and payment for home health
services would continue to apply.
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31. Concurrent Care for Beneficiaries that Elect the
Medicare Hospice Benefit
Current Requirements Proposed Waiver
Under current Medicare rules, when electing
hospice, beneficiaries must waive
Medicare coverage for services that are
considered curative in favor of receiving
services that are more palliative in nature.
However, studies have shown that offering
both palliative and curative care in hospice
can result in better pain and symptom
management, care coordination, and shared
decision making as well as timelier
incorporation of patient-centered goals into
the plan of care.
In addition, the stark decision required
between curative and hospice care negatively
impact a beneficiary’s access and ease of
transition to hospice.
Under the proposed waiver of the
requirements in Section 1812 and 42 CFR
Section 418.24(d)(2), DCEs would work with
hospice providers, as well as non-hospice
providers, to define and provide a set of
concurrent care services.
Services would be related to a hospice
enrollee’s terminal condition and associated
conditions that align with the enrollee’s wishes
and are appropriate to provide on a
transitional basis.
This waiver is expected to ease the transition
of care and enhance beneficiary choice for
beneficiaries, providing a tool for DCEs to
improve the quality of care.
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32. Concurrent Care for Beneficiaries that Elect the
Medicare Hospice Benefit: Requirements
This benefit enhancement would only be available to DCEs participating in the Global option of
Direct Contracting. Additional information regarding the Global option can be found in the Direct
Contracting Request for Application.
To be eligible, the concurrent care services that the DCE elects to make
available must be specified in the beneficiary’s plan of care and provided by
designated DC Participant Providers or Preferred Providers.
• These expenditures would be included as part of the total cost of care for the
relevant performance year for purposes of the Model financial calculations.
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33. Concurrent Care for Beneficiaries that Elect the
Medicare Hospice Benefit: Implementation
Medicare would continue existing claims-based edits to prevent non-hospice claims
from processing while a beneficiary is under hospice election, except with respect
to those hospice and non-hospice organizations identified by the DCE.
The Medicare FFS claims submitted by these organizations will be paid by Medicare if
they are otherwise appropriate for payment absent the restriction for paying claims for a
beneficiary that has elected hospice.
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35. Possible Future Benefit Enhancements and Patient
Engagement Incentives
Tiered Cost Sharing Reduction
Alternative Sites of Care
Cost-sharing Support for SNF Services
Long-Term Care Hospital 25-day Length of Stay and Other Site of
Care Restrictions
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36. Model Timeline
Timeline
Implementation Period
(IP) DCE Applicants
Performance Period
(PY1) DCE Applicants
Application Period
November 25, 2019 –
February 25, 2020
(Application tool available
December 20, 2019 [tentative])
March 2020 – May 2020
DCE Selection April 2020 September 2020
Deadline for applicants to
sign and return Participant
Agreement (PA)
Late April 2020
(Implementation Period PA)
December 2020
(Performance Period PA)
December 2020
Initial Voluntary Alignment
Outreach and start of IP or PY
May 2020 January 2021
This timeline may be subject to change. Please check the Directing Contracting webpage for webinar and office
hour dates and times.
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38. Upcoming Webinars
Webinar Date
Application Overview January 7, 2020
Office Hour Session for Questions and Answers - 2 January 8, 2020
Payment – Part 1
(Risk sharing, Risk Mitigation Cash Flow)
January 15, 2020
Payment – Part 2
(Risk Adjustment, Benchmarking, Quality)
January 22, 2020
Office Hour Session for Questions and Answers - 3
January 28, 2020
Office Hour Session for Questions and Answers - 4 February 11, 2020
*This timeline may be subject to change. Please check the Direct Contracting webpage for webinar and office hour dates
and times.
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39. Contact Information
Direct Contracting Webpage
(includes link to application):
https://innovation.cms.gov/initiatives/direct-contracting-model-options/
Email:
DPC@cms.hhs.gov
Salesforce Support:
CMMIForceSupport@cms.hhs.gov
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