Common use of ACO Legal Entity Clause in Contracts

ACO Legal Entity. ‌ 1. The ACO shall be a legal entity identified by a TIN formed under applicable state, federal, or tribal law, and authorized to conduct business in each state in which it operates for purposes of the following: (a) Receiving and distributing Shared Savings; (b) Repaying Shared Losses or Other Monies Owed to CMS; (c) Establishing, reporting, and ensuring Next Generation Participant compliance with health care quality criteria, including quality performance standards; and (d) Fulfilling ACO Activities identified in this Agreement. 2. If the ACO was formed by two or more Next Generation Participants, the ACO shall be a legal entity separate from the legal entity of any of its Next Generation Participants or Preferred Providers. 3. If the ACO was formed by a single Next Generation Participant, the ACO’s legal entity and governing body may be the same as that of the Next Generation Participant if the ACO satisfies the requirements of Section III.B. 4. The ACO is deemed to satisfy the requirements of Sections III.A.1 and III.A.2 if, as of the Effective Date, it was a Medicare Shared Savings Program (“MSSP”) ACO pursuant to a participation agreement (as defined at 42 CFR § 425.20). 5. During the term of this Agreement, the ACO shall not participate in the MSSP, the independence at home medical practice pilot program under section 1866E of the Act, another model tested or expanded under section 1115A of the Act that involves shared savings, or any other Medicare initiative that involves shared savings.

ACO Legal Entity. ‌ 1. The ACO shall be a legal entity identified by a TIN formed under applicable state, federal, or tribal law, and authorized to conduct business in each state in which it operates for purposes of the following: (a) Receiving and distributing Shared Savings; (b) Repaying Shared Losses or Other Monies Owed to CMS; (c) Establishing, reporting, and ensuring Next Generation Participant compliance with health care quality criteria, including quality performance standards; and (d) Fulfilling ACO Activities identified in this Agreement. 2. If the ACO was formed by two or more Next Generation Participants, the ACO shall be a legal entity separate from the legal entity of any of its Next Generation Participants or Preferred Providers. 3. If the ACO was formed by a single Next Generation Participant, the ACO’s legal entity and governing body may be the same as that of the Next Generation Participant if the ACO satisfies the requirements of Section III.B. 4. The ACO is deemed to satisfy the requirements of Sections III.A.1 and III.A.2 if, as of the Effective Date, it was a Medicare Shared Savings Program (“MSSP”) ACO pursuant to a participation agreement (as defined at 42 CFR C.F.R. § 425.20). 5. During the term of this Agreement, the ACO shall not participate in the MSSP, the independence at home medical practice pilot program under section 1866E of the Act, another model tested or expanded under section 1115A of the Act that involves shared savings, or any other Medicare initiative that involves shared savings.

ACO Legal Entity. ‌ 1. The ACO shall be a legal entity identified by a TIN formed under applicable state, federal, or tribal law, and authorized to conduct business in each state in which it operates for purposes of the following: (a) Receiving and distributing Shared Savings; (b) Repaying Shared Losses or Other Monies Owed to CMS; (c) Establishing, reporting, and ensuring Next Generation Participant compliance with health care quality criteria, including quality performance standards; and (d) Fulfilling ACO Activities identified in this Agreement. 2. If the ACO was formed by two or more Next Generation Participants, the ACO shall be a legal entity separate from the legal entity of any of its Next Generation Participants or Preferred Providers. 3. If the ACO was formed by a single Next Generation Participant, the ACO’s legal entity and governing body may be the same as that of the Next Generation Participant if the ACO satisfies the requirements of Section III.B. 4. The ACO is deemed to satisfy the requirements of Sections III.A.1 and III.A.2 if, as of the Effective Date, it was a Pioneer ACO pursuant to a Pioneer ACO Model Innovation Agreement or a Medicare Shared Savings Program (“MSSP”) ACO pursuant to a participation agreement (as defined at 42 CFR § 425.20). 5. During the term of this Agreement, the ACO shall not participate in the MSSP, the independence at home medical practice pilot program under section 1866E of the Act, another model tested or expanded under section 1115A of the Act that involves shared savings, or any other Medicare initiative that involves shared savings.

ACO Legal Entity. ‌ 1. The ACO shall be a legal entity identified by a TIN formed under applicable state, federal, or tribal law, and authorized to conduct business in each state in which it operates for purposes of the following: (a) Receiving and distributing Shared Savings; (b) Repaying Shared Losses or Other Monies Owed to CMS; (c) Establishing, reporting, and ensuring Next Generation Participant compliance with health care quality criteria, including quality performance standards; and (d) Fulfilling ACO Activities identified in this Agreement. 2. If the ACO was formed by two or more Next Generation Participants, the ACO shall be a legal entity separate from the legal entity of any of its Next Generation Participants or Preferred Providers. 3. If the ACO was formed by a single Next Generation Participant, the ACO’s legal entity and governing body may be the same as that of the Next Generation Participant if the ACO satisfies the requirements of Section III.B. 4. The ACO is deemed to satisfy the requirements of Sections III.A.1 and III.A.2 if, as of the Effective Date, it was a Pioneer ACO pursuant to a Pioneer ACO Model Innovation Agreement or a Medicare Shared Savings Program (“MSSP”) ACO pursuant to a participation agreement (as defined at 42 CFR C.F.R. § 425.20). 5. During the term of this Agreement, the ACO shall not participate in the MSSP, the independence at home medical practice pilot program under section 1866E of the Act, another model tested or expanded under section 1115A of the Act that involves shared savings, or any other Medicare initiative that involves shared savings.

ACO Legal Entity. ‌ 1. The ACO shall be a legal entity identified by a TIN formed under applicable state, federal, or tribal law, and authorized to conduct business in each state in which it operates for purposes of the following: (a) Receiving and distributing Shared Savings; (b) Repaying Shared Losses or Other Monies Owed to CMS; (c) Establishing, reporting, and ensuring Next Generation Participant compliance with health care quality criteria, including quality performance standards; and (d) Fulfilling ACO Activities identified in this Agreement. 2. If the ACO was formed by two or more Next Generation Participants, the ACO shall be a legal entity separate from the legal entity of any of its Next Generation Participants or Preferred Providers. 3. If the ACO was formed by a single Next Generation Participant, the ACO’s legal entity and governing body may be the same as that of the Next Generation Participant if the ACO satisfies the requirements of Section III.B. 4. The ACO is deemed to satisfy the requirements of Sections III.A.1 and III.A.2 if, as of the Effective Date, it was a Pioneer ACO pursuant to a Pioneer ACO Model Innovation Agreement or a Medicare Shared Savings Program (“MSSP”) ACO pursuant to a participation agreement (as defined at 42 CFR C.F.R. § 425.20). 5. During the term of this Agreement, the ACO shall not participate in the MSSP, the independence at home medical practice pilot program under section 1866E of the Act, another model tested or expanded under section 1115A of the Act that involves shared savings, or any other Medicare initiative that involves shared savings.