ACO Selections Clause Samples
ACO Selections.
A. The parties acknowledge that the ACO was required to submit its selections for the following in advance of the Effective Date by a date and in a form and manner specified by CMS:
1. The ACO’s Risk Sharing Option (Professional or Global) for the ACO’s first Performance Year subject to the requirements of Section 8.01.D;
2. The ACO’s selected Capitation Payment Mechanism for the ACO’s first Performance Year;
3. The ACO’s selection whether to participate in the APO for the ACO’s first Performance Year, if the ACO selected PCC Payment as its Capitation Payment Mechanism for the ACO’s first Performance Year;
4. The maximum Enhanced PCC Percentage for the ACO’s first Performance Year within the range specified in Appendix E, if the ACO selected PCC Payment as its Capitation Payment Mechanism for the ACO’s first Performance Year;
5. The Benefit Enhancements or Beneficiary Engagement Incentives, if any, that the ACO selected to offer with its Participant Providers and Preferred Providers during the ACO’s first Performance Year;
6. The ACO’s selected Alignment Methodology (Prospective Alignment or Prospective Plus Alignment) for the ACO’s first Performance Year;
7. The ACO’s decision with respect to participation in SVA for the ACO’s first Performance Year. The ACO’s decision with respect to participation in SVA for the ACO’s first Performance Year refers to the ACO’s decision to participate in Voluntary Alignment Activities specific to SVA in accordance with Appendix C during the ACO’s first Performance Year for purposes of: (1) aligning Beneficiaries to the ACO for the ACO’s second Performance Year; and (2) aligning Beneficiaries to the ACO for the second, third, and fourth calendar quarters of the ACO’s first Performance Year, provided that the ACO has selected Prospective Plus Alignment for the ACO’s first Performance Year and submits an SVA List (as described in Appendix C) to CMS in advance of the relevant calendar quarter; and
8. The ACO’s decision whether to participate in Provisional Financial Settlement for the ACO’s first Performance Year.
B. In a form and manner and by the date(s) specified by CMS, the ACO shall submit to CMS:
1. Its selection whether to participate in a Stop-Loss Arrangement for the ACO’s first Performance Year; and
2. An update to the maximum Enhanced PCC Percentage for the ACO’s first Performance Year within the range specified in Appendix E, if the ACO selected PCC Payment as its Capitation Payment Mechanism for the ACO’s first...
ACO Selections. The ACO has submitted, or shall submit, to CMS its selections for the following by one or more deadlines and in a manner determined by CMS in advance of the Start Date:
1. The ACO’s selected Risk Arrangement from the alternatives described in Appendix B;
2. The ACO’s selected Savings/Losses Cap, between 5.0% and 15.0%;
3. The ACO’s selection of AIPBP as an Alternative Payment Mechanism; and
4. The ACO’s selection of all three Benefit Enhancements.
ACO Selections. For each Performance Year, by a date and in a manner determined by CMS, the ACO shall notify CMS of the following:
1. The ACO’s selected Risk Arrangement from the alternatives described in Appendix B;
2. The ACO’s selected Alternative Payment Mechanism, if any;
3. The Benefit Enhancements, if any, that it elects to offer through its Next Generation Participants and Preferred Providers; and