Common use of Factors Clause in Contracts

Factors. Each element is comprised of multiple factors that are outlined in the MOC upload matrix in the Demonstration Plan application. The factors for each element will be scored using a system from zero to four, where four is the highest score for a factor. Demonstration Plans are required to provide a response that addresses every factor within each of the eleven elements. The scores for each factor within a specific element are totaled to provide the overall score for that element out of a total of 160 possible points. Demonstration Plans must achieve a minimum score of 70% to meet the CMS approval standard. It is CMS’ intent for MOC reviews and approvals to be a multi-year process that will allow Demonstration Plans to be granted up to a three-year approval of their MOC based on higher MOC scores above the passing standard. The specific time periods for approvals are as follows: • Plans that receive a score of 85% or higher will be granted an approval of the CMS MOC requirement for three years. • Plans that receive a score in the 75% to 84% range will be granted an approval of the CMS MOC requirement for two years. • Plans that receive a score in the 70% to 74% range will be granted an approval of the CMS MOC requirement for one year. Demonstration Plans will be permitted to cure problems with their MOC submissions after their initial submission. Demonstration Plans with MOCs scoring below 85% will have the opportunity to improve their scores based on CMS and State feedback on the elements and factors that need additional work. At the end of the review process, MOCs that do not meet CMS’ standards for approval will not be eligible for selection as Demonstration Plans.

Factors. Each element is comprised of multiple factors that are outlined in the MOC upload matrix in the Demonstration Plan application. The factors for each element will be scored using a system from zero to four, where four is the highest score for a factor. Demonstration Plans are required to provide a response that addresses every factor within each of the eleven elements. The scores for each factor within a specific element are totaled to provide the overall score for that element out of a total of 160 possible points. Demonstration Plans must achieve a minimum score of 70% to meet the CMS approval standard. It is CMS’ intent for MOC reviews and approvals to be a multi-year process that will allow Demonstration Plans to be granted up to a three-year approval of their MOC based on higher MOC scores above the passing standard. The specific time periods for approvals are as follows: •  Plans that receive a score of 85% or higher will be granted an approval of the CMS MOC requirement for three years. •  Plans that receive a score in the 75% to 84% range will be granted an approval of the CMS MOC requirement for two years. •  Plans that receive a score in the 70% to 74% range will be granted an approval of the CMS MOC requirement for one year. Demonstration Plans will be permitted to cure problems with their MOC submissions after their initial submission. Demonstration Plans with MOCs scoring below 85% will have the opportunity to improve their scores based on CMS and State feedback on the elements and factors that need additional work. At the end of the review process, MOCs that do not meet CMS’ standards for approval will not be eligible for selection as Demonstration Plans.

Factors. Each element is comprised of multiple factors that are outlined in the MOC upload matrix in the Demonstration Participating Plan application. The factors for each element will be scored using a system from zero to four, where four is the highest score for a factor. Demonstration Participating Plans are required to provide a response that addresses every factor within each of the eleven elements. The scores for each factor within a specific element are totaled to provide the overall score for that element out of a total of 160 possible points. Demonstration Participating Plans must achieve a minimum score of 70% to meet the CMS approval standard. It is CMS’ intent for MOC reviews and approvals to be a multi-year process that will allow Demonstration Participating Plans to be granted up to a three-year approval of their MOC based on higher MOC scores above the passing standard. The specific time periods for approvals are as follows: • ● Plans that receive a score of 85% or higher will be granted an approval of the CMS MOC requirement for three years. • ● Plans that receive a score in the 75% to 84% range will be granted an approval of the CMS MOC requirement for two years. • ● Plans that receive a score in the 70% to 74% range will be granted an approval of the CMS MOC requirement for one year. Demonstration Participating Plans will be permitted to cure problems with their MOC submissions after their initial submissionsubmissions. Demonstration Participating Plans with MOCs scoring below 85% 85 percent will have the opportunity to improve their scores based on CMS and State Commonwealth feedback on the elements and factors that need additional work. At the end of the review process, MOCs that do not meet CMS’ standards for approval will not be eligible for selection as Demonstration Participating Plans.