Provision of Certain Claims Data and Beneficiary Reports. A. CMS believes that the health care operations work of the ACO (that is acting on its own behalf as a HIPAA covered entity (CE) or that is a business associate (BA) acting on behalf of its Participant Providers or Preferred Providers that are HIPAA CEs) would benefit from the receipt of certain beneficiary- identifiable data on REACH Beneficiaries and Beneficiaries who have been excluded from alignment to the ACO, including Originally Aligned Beneficiaries. CMS will therefore offer to the ACO an opportunity to request specific Beneficiary-identifiable data by completing the HIPAA-Covered Data Disclosure Request Form. This data set will not include SUD data; however, CMS will notify the ACO in writing if CMS subsequently elects to offer the ACO an opportunity to request Beneficiary-identifiable SUD data by completing the HIPAA-Covered Data Disclosure Request Form. All requests for Beneficiary- identifiable claims data will be granted or denied at CMS’ sole discretion based on CMS’s available resources and technological capabilities, the limitations in the Agreement, and applicable law.
Provision of Certain Claims Data and Beneficiary Reports. A. CMS believes that the health care operations work of the DCE (that is acting on its own behalf as a HIPAA covered entity (CE) or that is a business associate (BA) acting on behalf of its DC Participant Providers or Preferred Providers that are HIPAA CEs) would benefit from the receipt of certain beneficiary-identifiable claims data on Originally Aligned Beneficiaries and DC Beneficiaries. CMS will therefore offer to the DCE an opportunity to request specific Beneficiary- identifiable data by completing the HIPAA-Covered Data Disclosure Request Form. This data set will not include substance use disorder data; however, CMS will notify the DCE in writing if CMS subsequently elects to offer the DCE an opportunity to request Beneficiary-identifiable substance use disorder data by completing the HIPAA-Covered Data Disclosure Request Form. All requests for Beneficiary-identifiable claims data will be granted or denied at CMS' sole discretion based on CMS' available resources and technological capabilities, the limitations in the Agreement, and applicable law.
Provision of Certain Claims Data and Beneficiary Reports. 58 Section 6.03 De-Identified Reports 64 Section 6.04 Beneficiary Rights to Opt Out of Data Sharing 64
Provision of Certain Claims Data and Beneficiary Reports
