Next Generation Participant definition

Next Generation Participant means an individual or entity that:
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Next Generation Participant means an individual or group of Professionals that is identified by a Medicare-enrolled TIN that alone or together with one or more other Next Generation Participant(s) comprise(s) an ACO, and that is included on the list of Next Generation Participants submitted by ACO to CMMI and updated at the start of each Performance Year and at other times as specified by CMMI.
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Examples of Next Generation Participant in a sentence

  • These reductions in FFS payments will not be included in the calculation of the base-year or Performance-Year expenditure of the ACO (i.e., the baseline and Performance-Year expenditure will be the amount that would have been paid to the Next Generation Participant if the Population-Based Payment Fee Reductions had not been made).

  • This Program Addendum will terminate prior to the end of the Term if DVHA requires the ACO to remove the Next Generation Participant from the approved list of providers.

  • The Next Generation ACO has entered into an AIPBP Payment Arrangement with the AIPBP-participating Next Generation Participant or Preferred Provider that establishes how the Next Generation ACO will make payments for Covered Services that are subject to the AIPBP Fee Reduction.

  • This waiver does not, however, protect the provision of an item or service if a reasonable Beneficiary would perceive the item or service as being from the agent, rather than from the Next Generation ACO or Next Generation Participant.

  • The removal of the individual or entity from the Participant List or Preferred Provider List will be effective on the date the individual or entity ceased to be a Next Generation Participant or Preferred Provider.

  • An individual or entity ceases to be a Next Generation Participant or Preferred Provider when it is no longer a Medicare-enrolled provider or supplier, when its agreement with the ACO to participate in the Model terminates, or when it ceases to bill for items and services furnished to Beneficiaries under a Medicare billing number assigned to a TIN in accordance with applicable Medicare regulations.

  • Participant warrants that it has the authority to and does bind itself and its employees, including each Provider with an NPI number billing under its TIN who is included on the Vermont Medicaid Next Generation Participant List to the Agreement and this Program Addendum.

  • Participation in AIPBP requires a Next Generation Participant or Preferred Provider to continue offering Covered Services to Next Generation Beneficiaries, with a 100% reduction in fee-for-service payments from CMS for those services.

  • For example, an arrangement between a Next Generation ACO and a Next Generation Participant or Preferred Provider for payment or recoupment of Shared Losses or Other Monies Owed, which relate to participation in ACO Activities, could be protected by the Next Generation ACO Participation Waiver if all waiver conditions are met.

  • Xxxxxxxx to section 1899(b)(4)(A) of the Act, a Next Generation Participant may not also be an ACO participant, ACO provider/supplier and/or ACO professional in an accountable care organization in the MSSP.

Related to Next Generation Participant

  • FTR Participant means any Market Participant that provides or is required to provide Collateral in order to participate in PJM’s FTR auctions.

  • Program participant means an individual certified by the secretary as a program participant under Iowa Code section 9E.3.

  • Inactive Participant means each Participant (other than a Retired Participant, Deceased Participant or Disabled Participant) who is not in active service as an Outside Director and is not actively employed by a Participating Company.

  • Plan Participant means a person who is eligible to receive, and is receiving, a pension benefit from the Plan.

  • Study Participant means a person recruited to participate in the Study.

  • L/C Participant shall have the meaning provided in Section 3.3(a).

  • Disabled Participant with respect to a loan if it has no right to exercise any voting or other control rights with respect to such loan (other than the right to approve amendments to the material economic terms of such loan).

  • CDS Participant means a participant in CDS that holds security entitlements in Units on behalf of beneficial owners of those Units;

  • Designated Participant means a key Employee of the Company or any other Participating Company who is designated by the Committee in writing to participate in the Program.

  • Current Participant means a person who participated in the Plan during the Class Period and had an Active Account on May 11, 2018.

  • Qualified Participant means a Participant who has attained age 55 and who has completed at least 10 years of participation in the Plan.

  • Participant has the meaning specified in Section 10.06(d).

  • Active Participant means, with respect to any day or date, a Participant who is in Service on such day or date; provided, that a Participant shall cease to be an Active Participant (i) immediately upon a determination by the Committee that the Participant has ceased to be an Employee or Independent Contractor, or (ii) at the end of the Plan Year that the Committee determines the Participant no longer meets the eligibility requirements of the Plan.

  • Market Participant means an entity that, for its own account, produces, transmits, sells, and/or purchases for its own consumption or resale capacity, energy, energy derivatives and ancillary services in the wholesale power markets. Market Participants include transmission service customers, power exchanges, Transmission Owners, load serving entities, loads, holders of energy derivatives, generators and other power suppliers and their designated agents.

  • Basic generation service provider or "provider" means a

  • Project Participant means a member of the Project Team.

  • Retired Participant means a person who has been a Participant, but who has become entitled to retirement benefits under the Plan.

  • Non-Highly Compensated Participant means any Participant who is neither a Highly Compensated Employee nor a Family Member.

  • Plan Account means the account established for each Participant pursuant to Section 8(a).

  • Reporting Participant means a Participant who is subject to the reporting requirements of Section 16 of the Exchange Act.

  • Service benefit means the credit toward retirement benefits as determined by the

  • Market Participant Energy Injection means transactions in the Day-ahead Energy Market and Real-time Energy Market, including but not limited to Day-ahead generation schedules, real- time generation output, Increment Offers, internal bilateral transactions and import transactions, as further described in the PJM Manuals.

  • Highly Compensated Participant means any Highly Compensated Employee who is eligible to participate in the Plan.

  • U.S. Participant means a Participant who is a citizen of the United States or a resident of the United States, as defined in section 7701(a)(30)(A) and section 7701(b)(1) of the Code and any other Participant who is subject to tax under the Code with respect to compensatory awards granted pursuant to the Plan;

  • Other Participant means a cooperative project participant other than the United States.

  • Market Participant Energy Withdrawal means transactions in the Day-ahead Energy Market and Real-time Energy Market, including but not limited to Demand Bids, Decrement Bids, real-time load (net of Behind The Meter Generation expected to be operating, but not to be less than zero), internal bilateral transactions and Export Transactions, as further described in the PJM Manuals. Market Seller Offer Cap: