Medicare Authority. The Medicare elements of the initiative shall operate according to existing Medicare Parts C and D laws and regulation, as amended or modified, except to the extent these requirements are waived or modified as provided for in Appendix 4. As a term and condition of the Demonstration, Plans will be required to comply with Medicare Advantage and Medicare Prescription Drug Program requirements in Part C and Part D of Title XVIII of the Social Security Act, and 42 CFR §422 and 423, and applicable sub- regulatory guidance, as amended from time to time, except to the extent specified in this MOU, including Appendix 4 and, for waivers of sub-regulatory guidance, the Three-way Contract.
Medicare Authority. The Medicare portions of the Model shall operate according to Medicare law, regulation, and sub-regulatory guidance, and are subject to all existing requirements, including financial and program integrity requirements, except to the extent these requirements are waived or modified in separately issued documentation.
Medicare Authority. The Medicare portions of the Demonstration shall operate according to existing Medicare law, regulation, and sub-regulatory guidance and are subject to existing requirements for financial and program integrity, except to the extent these requirements are waived or modified as provided for in Appendix 4.
Medicare Authority. The Medicare elements of the initiative shall operate according to existing Medicare Parts C and D laws and regulations, as amended or modified, except to the extent these requirements are waived or modified as provided for in Appendix 4. As a term and condition of the initiative, ICDS Plans will be required to comply with Medicare Advantage and Medicare Prescription Drug Program requirements in Part C and Part D of Title XVIII of the Social Security Act, and 42 C.F.R. 422 and 423, and applicable sub- regulatory guidance, as amended from time to time, except to the extent specified in this MOU, including Appendix 4 and, for waivers of sub-regulatory guidance, the three-way contract.
Medicare Authority. The Medicare elements of the Demonstration shall operate according to existing Medicare Parts C and D laws and regulations, as amended or modified, except to the extent these requirements are waived or modified as provided for in Appendix 1. MAP plans and FIDE SNPs with exclusively aligned enrollment participating in the MAP program will continue to comply with all Medicare Advantage and Medicare Prescription Drug Program requirements in Part C and Part D of Title XVIII of the Social Security Act, and 42 CFR Parts 422 and 423, and applicable subregulatory guidance, as amended from time to time, except to the extent specified in this MOU. Medicare Waiver Approval: CMS approval of Medicare waivers is reflected in Appendix 1. CMS reserves the right to withdraw waivers or expenditure authorities at any time it determines that continuing the waivers or expenditure authorities would no longer be in the public interest or promote the objectives of Title XVIII. CMS will promptly notify the State in writing of the determination and the reasons for the withdrawal, together with the effective date, and afford the State a reasonable opportunity to request reconsideration of CMS’ determination prior to the effective date. The demonstration will continue during the pendency of any CMS-state discussions regarding termination of the demonstration. Termination and phase out would proceed as described in section III.J of this MOU. If a waiver or expenditure authority is withdrawn, Federal financial participation (“FFP”) is limited to normal closeout costs associated with terminating the waiver or expenditure authority.
Medicare Authority. Section 111 5A(b) of the Act authorizes CMS, through the Innovation Center, to enter into this Agreement. Medicare reimbursement under this Model shall continue to operate consistent with all applicable laws, regulations and guidance, as amended or modified, except to the extent these requirements are waived in accordance with Section 111 5A(d)(I) of the Act as set forth in this Agreement. As a term and condition of this Model, the State will require that all hospitals in the State of Maryland for which payments are regulated by the State for all payers including Medicare, as listed in Appendix 1 and as updated from time to time (hereafter "Regulated Maryland Hospitals"), will comply in all material respects with Medicare requirements in Title XVIII of the Act and all implementing regulations, insofar as not waived herein, and applicable guidance, as amended from time to time.
