Common use of ACO Obligations and Limitations Regarding the Coordinated Care Reward Clause in Contracts

ACO Obligations and Limitations Regarding the Coordinated Care Reward. ‌ 1. In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO shall ensure that all Next Generation Participants and Preferred Providers will, upon any Next Generation Beneficiary’s inquiry about the Coordinated Care Reward, provide an accurate and current list of all Next Generation Participants and Preferred Providers, either in hard copy or by reference to the ACO’s website, to the Next Generation Beneficiary. 2. In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO shall ensure that all Next Generation Beneficiaries will be directed by the ACO, Next Generation Participants, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities to 1-800-MEDICARE to obtain additional information about the Coordinated Care Reward. 3. In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO and its Next Generation Participants and Preferred Providers may communicate in writing with Next Generation Beneficiaries regarding the Coordinated Care Reward. Any such written materials must comply with the requirements under Section V.E of this Agreement. 4. In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO shall ensure that any communication with Next Generation Beneficiaries regarding the Coordinated Care Reward, whether by the ACO, a Next Generation Participant, Preferred Provider, or other individuals or entities performing functions or services related to ACO Activities clearly conveys that CMS is solely responsible for the terms and payment of the Coordinated Care Reward and that the reward does not limit Beneficiaries’ freedom of choice of Medicare providers and suppliers. 5. The ACO shall not, and shall ensure that its Next Generation Participants, Preferred Providers, and any other individuals or entities performing services related to ACO Activities do not, provide gifts or other remuneration to Next Generation Beneficiaries as inducements for receiving the Coordinated Care Reward or to influence a Next Generation Beneficiary’s decision to qualify for the Coordinated Care Reward.

ACO Obligations and Limitations Regarding the Coordinated Care Reward. ‌ 1. In any Performance Year in which If CMS elects to make Coordinated Care Reward paymentspayments during the Performance Year, the ACO shall ensure that all Next Generation Participants and Preferred Providers will, upon any Next Generation Beneficiary’s inquiry about the Coordinated Care Reward, provide an accurate and current list of all Next Generation Participants and Preferred Providers, either in hard copy or by reference to the ACO’s website, to the Next Generation Beneficiary. 2. In any Performance Year in which If CMS elects to make Coordinated Care Reward paymentspayments during the Performance Year, the ACO shall ensure that all Next Generation Beneficiaries will be directed by the ACO, Next Generation Participants, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities to 1-800-MEDICARE to obtain additional information about the Coordinated Care Reward. 3. In any Performance Year in which If CMS elects to make Coordinated Care Reward paymentspayments during the Performance Year, the ACO and its Next Generation Participants and Preferred Providers may communicate in writing with Next Generation Beneficiaries regarding the Coordinated Care Reward. Any such written materials must comply with the requirements under Section V.E of this Agreement. 4. In any Performance Year in which If CMS elects to make Coordinated Care Reward paymentspayments during the Performance Year, the ACO shall ensure that any communication with Next Generation Beneficiaries regarding the Coordinated Care Reward, whether by the ACO, a Next Generation Participant, Preferred Provider, or other individuals or entities performing functions or services related to ACO Activities clearly conveys that CMS is solely responsible for the terms and payment of the Coordinated Care Reward and that the reward does not limit the Beneficiaries’ freedom of choice of Medicare providers and suppliers. 5. The ACO shall not, and shall ensure that its Next Generation Participants, Preferred Providers, and any other individuals or entities performing services related to ACO Activities do not, provide gifts or other remuneration to Next Generation Beneficiaries as inducements for receiving the Coordinated Care Reward or to influence a Next Generation Beneficiary’s decision to qualify for the Coordinated Care Reward.