Common use of Beneficiary Rights to Opt Out of Data Sharing Clause in Contracts

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costs. B. The ACO shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO may affirmatively contact a REACH Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO Professional is terminated from the ACO for any reason, if that departing ACO Professional is the sole ACO Professional in the ACO to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has selected another ACO Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA or SVA) or has become the patient of another Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD data sharing as described in Section 6.02.A, the ACO shall receive claims data regarding SUD treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. (a) The ACO MDPCP Practice shall provide MDPCP Beneficiaries who inquire about or and wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with the MDPCP Practice and, if applicable, the MDPCP Practice’s MDPCP Partner CTOs with information about how to modify their data sharing preferences. The MDPCP Practice shall inform them that they may modify their data sharing preferences by submitting a beneficiary data sharing form provided by CMS (“MDPCP Beneficiary Data Sharing Form”) to CMS via 1the MDPCP Practice or by contacting the MDPCP helpdesk via phone at 0-800000-MEDICARE000-0000 option number 7. Such communications shall note that, even if a an MDPCP Beneficiary has elected to decline claims data sharingsharing for purposes of the recipient’s health care operations, CMS may still prospectively reserve the right to engage in certain limited claims data sharing for care coordination its own healthcare operations and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costspayment purposes. B. (b) The ACO MDPCP Practice shall allow MDPCP Beneficiaries to reverse a claims data sharing preference at any time by calling 0submitting the MDPCP Beneficiary Data Sharing Form to CMS or by contacting the MDPCP helpdesk via phone at 1-844- 000-XXXXXXXX0000 option number 7. C. (c) CMS will maintain the data sharing preferences of MDPCP Beneficiaries who elect to decline claims data sharing in this Model or who have previously declined data sharing under for the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Modelrecipients’ health care operations purposes. D. (d) The ACO MDPCP Practice may affirmatively contact a REACH MDPCP Beneficiary who has elected to decline claims data sharing no more than one time during in a given Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with MDPCP Beneficiaries outside of a clinical setting. E. (e) In the event that an ACO Professional MDPCP Practitioner is terminated from the ACO MDPCP Practice for any reason, if that departing ACO Professional MDPCP Practitioner is the sole ACO Professional MDPCP Practitioner in the ACO MDPCP Practice to have submitted claims for a particular MDPCP Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the MDPCP Beneficiary out of all claims data-sharing with the MDPCP Practice and, if applicable, the MDPCP Practice’s MDPCP Partner CTOs under Section 6.02.C.2 this Article X within 30 Days of the effective date of the termination, unless unless— (i) The MDPCP Beneficiary affirmatively authorizes the continued sharing of such claims data with the MDPCP Practice and, if applicable, the MDPCP Practice’s MDPCP Partner CTOs through an authorization that meets the requirements under 45 CFR § 164.508(b); or (ii) The MDPCP Beneficiary has selected another ACO Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA or SVA) or has become subsequently becomes the patient of another Participant Provider or Preferred ProviderMDPCP Practitioner within the MDPCP Practice, as described in Article 10.4(f). F. (f) CMS will administratively opt an MDPCP Beneficiary back into such claims data sharing if he or she was administratively opted out of such claims data sharing solely due to the termination of his or her only treating MDPCP Practitioner within the MDPCP Practice if he or she is subsequently re-attributed to the same MDPCP Practice due to becoming a patient of another current MDPCP Practitioner. In those cases, CMS will administratively opt the beneficiary back into such claims data sharing, unless the MDPCP Beneficiary affirmatively opts out of data sharing in accordance with this Article 10.4. (g) Notwithstanding the foregoing, the MDPCP Practice and, if CMS elects to offer SUD data sharing as described in Section 6.02.A, applicable the ACO MDPCP Practice’s MDPCP Partner CTOs shall receive claims data regarding SUD substance use disorder treatment only if the MDPCP Beneficiary has submitted a CMS-approved form electing to share Part 2-covered data with the MDPCP Practice and, if applicable, the MDPCP Practice’s MDPCP Partner CTOs in accordance with Article 10.5 of this Agreement and has not elected to decline data sharing or otherwise been opted out of data sharing and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05sharing.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO DCE shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costsimprovement. B. The ACO DCE shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO DCE may affirmatively contact a REACH DC Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO a DC Professional is terminated from the ACO DCE for any reason, if that departing ACO DC Professional is the sole ACO DC Professional in the ACO DCE to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has had selected another ACO DC Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA Electronic Voluntary Alignment or SVAPaper-Based Voluntary Alignment) or has become the patient of another DC Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD substance use disorder data sharing as described in Section 6.02.A, the ACO DCE shall receive claims data regarding SUD substance use disorder treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing sharing, and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.056.05 of the Agreement.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costs. B. The ACO shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO may affirmatively contact a REACH Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO Professional is terminated from the ACO for any reason, if that departing ACO Professional is the sole ACO Professional in the ACO to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has selected another ACO Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA or SVA) or has become the patient of another Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD data sharing as described in Section 6.02.A, the ACO shall receive claims data regarding SUD treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO DCE shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH DC Beneficiaries, and population-based activities relating to improving health or reducing health care costs. B. The ACO DCE shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO DCE may affirmatively contact a REACH DC Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO a DC Professional is terminated from the ACO DCE for any reason, if that departing ACO DC Professional is the sole ACO DC Professional in the ACO DCE to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has selected another ACO DC Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA Electronic Voluntary Alignment or SVAPaper-Based Voluntary Alignment) or has become the patient of another DC Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD data sharing as described in Section 6.02.A, the ACO DCE shall receive claims data regarding SUD treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing sharing, and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costs. B. The ACO shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO may affirmatively contact a REACH Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO Professional is terminated from the ACO for any reason, if that departing ACO Professional is the sole ACO Professional in the ACO to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has selected another ACO Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA or SVA) or has become the patient of another Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD data sharing as described in Section 6.02.A, the ACO shall receive claims data regarding SUD treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing sharing, and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05.

Beneficiary Rights to Opt Out of Data Sharing. ‌ A. The ACO shall provide Beneficiaries who inquire about or wish to modify their preferences regarding claims data sharing for care coordination and quality improvement purposes with information about how to modify their data sharing preferences via 1-800-MEDICARE. Such communications shall note that, even if a Beneficiary has elected to decline claims data sharing, CMS may still engage in certain limited data sharing for care coordination and quality improvement activities for REACH Beneficiaries, and population-based activities relating to improving health or reducing health care costs. B. The ACO shall allow Beneficiaries to reverse a data sharing preference at any time by calling 0-000-XXXXXXXX. C. CMS will maintain the data sharing preferences of Beneficiaries who elect to decline data sharing in this Model or who have previously declined data sharing under the Medicare Shared Savings Program, the Pioneer ACO Model, or the Next Generation ACO Model. D. The ACO may affirmatively contact a REACH Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing. Such contact includes mailings, phone calls, electronic communications, or other methods of communicating with Beneficiaries outside of a clinical setting. E. In the event that an ACO Professional is terminated from the ACO for any reason, if that departing ACO Professional is the sole ACO Professional in the ACO to have submitted claims for a particular Beneficiary during the 12-month period prior to the effective date of the termination, CMS will administratively opt the Beneficiary out of all claims data-sharing under Section 6.02.C.2 within 30 Days of the effective date of the termination, unless the Beneficiary has selected another ACO Professional as his or her main doctor, main provider, and/or main place they receive care (whether through MVA or SVA) or has become the patient of another Participant Provider or Preferred Provider. F. Notwithstanding the foregoing, if CMS elects to offer SUD data sharing as described in Section 6.02.A, the ACO shall receive claims data regarding SUD treatment only if the Beneficiary has not elected to decline data sharing or otherwise been opted out of data sharing sharing, and has also submitted a CMS-approved SUD opt in form pursuant to Section 6.05.