Shared Losses definition

Shared Losses means the monetary amount owed to CMS by the ACO due to expenditures for Medicare Part A and Part B items and services furnished to REACH Beneficiaries during a Performance Year in excess of the Performance Year Benchmark. The amount of Shared Losses is determined by CMS in accordance with Appendix B and the Risk Sharing Option and Capitation Payment Mechanism selected by the ACO.

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Shared Losses means the monetary amount owed to a payer by an ACO as determined by comparing the ACO’s expenditures for aligned beneficiaries against the ACO Benchmark for that payer.

Shared Losses has the meaning set forth in the Financial Definitions Exhibit.

Examples of Shared Losses in a sentence

• CMS may condition its consent to such transfer on full or partial reconciliation of Shared Losses and Other Monies Owed.

• For any Performance Year for which the ACO selects to participate in Provisional Financial Settlement as described in Section 8.01, CMS will conduct Provisional Financial Settlement and issue a settlement report to the ACO setting forth the provisional amount of Shared Savings or Shared Losses, and the provisional net amount owed by either CMS or the ACO for the Performance Year.

• CMS shall calculate Shared Savings or Shared Losses according to the methodology in Appendix B and shall calculate the amount of Other Monies Owed according to the methodology in Appendices B, E through G, I, J, L through O, and T.

• The ACO must have the ability to repay all Shared Losses and Other Monies Owed for which it may be liable under the terms of the Agreement and shall provide a financial guarantee in accordance with terms set forth in Appendix H.

• Regardless of whether the ACO selects to participate in Provisional Financial Settlement for a Performance Year, following the end of each Performance Year, and at such other times as may be required under the Agreement, CMS will conduct Final Financial Settlement and issue a settlement report to the ACO setting forth the amount of any Shared Savings or Shared Losses, the amount of Other Monies Owed, and the net amount owed by either CMS or the ACO for the Performance Year.

• The accuracy, completeness, and truthfulness of all data and information that are generated or submitted by the ACO, Participant Providers, Preferred Providers, or other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, including any quality data or other information or data relied upon by CMS in determining the ACO’s eligibility for, and the amount of Shared Savings, or the amount of Shared Losses or Other Monies Owed.

• If this Agreement is terminated by CMS under Section XIX.B, CMS shall not make any payments of Shared Savings to the ACO, and the ACO shall remain liable for any Shared Losses, for the Performance Year in which termination becomes effective.

• The Risk Arrangement selected by the ACO in accordance with Section X.A of the Agreement will determine the portion of the aggregate gross savings or losses in relation to the Performance Year Benchmark that accrue to the ACO as Shared Savings or Shared Losses.

• Nothing in this Agreement or its Appendices shall be construed to limit the ACO’s liability to pay any Shared Losses or Other Monies Owed in excess of the amount of the financial guarantee.

• Moreover, Participant, Preferred Provider and ACO will be required to meet all financial obligations for the Performance Year when notice is given, including Shared Losses and Savings.

More Definitions of Shared Losses

Shared Losses shall have the meaning set forth in Section 7.3(m).

Shared Losses means any and all Losses paid to a Third Party or incurred in connection with defending a Third Party claim relating to this Agreement or the Parties’ activities hereunder other than those for which a Party has an obligation of indemnification under Section 19.1. The Parties shall confer, through the JSC, as to how to respond to any such claims and how to handle such claims in an efficient manner and shall fully cooperate in the resolution of such issues.

Shared Losses means the amount by which the observed Performance Period Total Cost of Care is in excess of the adjusted Total Cost of Care target for the Performance Period after the IHP Entity exceeds the performance threshold as described in Section 15.‌

Shared Losses means the amount by which the observed Performance Period Total Cost of Care is in excess of the adjusted Total Cost of Care target for the Performance Period after the IHP Entity exceeds the performance threshold as described in Attachment B-1, IHP-Specific Governance and Financial Settlement Information

Shared Losses means (i) the corrective or remedial costs incurred by the Buyer Indemnified Persons in implementing any corrective or remedial action in response to a Warranty Breach (including any “toll charges” payable to the Internal Revenue Service), and (ii) the costs incurred by the Buyer Indemnified Persons in implementing any Mitigation Action in response to a Warranty Breach (including any “toll charges” payable to the Internal Revenue Service) but excluding from the Shared Losses for purposes of clause (i) and (ii) the costs set forth on Schedule 10.02(a)(iv)(A)) . For the avoidance of doubt, the term “Shared Losses” does not include (1) judicial awards and judgments, settlements, regulatory fines and penalties (including any Losses incurred in implementing any corrective or remedial actions to the extent expressly required by, and benefiting the Persons covered by, the terms of such judicial awards, judgments or settlements or regulatory fines or penalties), and (2) any costs of the types contemplated in clauses (i) and (ii) of the foregoing sentence to the extent arising (x) solely out of a Claim or (y) both a Claim and a Warranty Breach (but only to the extent arising out of such Claim).

Shared Losses shall have the meaning assigned thereto in Section 11.8(a).