CMS Duties Sample Clauses

CMS Duties i. CMS, in collaboration with the GMCB, will determine the parameters and requirements of the Initiative including governance, beneficiary alignment methodology, payment mechanisms, risk arrangements, and benefit enhancements. CMS may exercise its authority to modify or set the Vermont Medicare ACO Initiative Benchmarks as articulated in sections 7.c and 9.d. ii. For Performance Year 1 of the Model, CMS shall execute Vermont Modified Next Generation ACO participation agreements with eligible Vermont ACOs that are based on the Next Generation ACO Model participation agreements, but are amended to reflect the GMCB’s role in setting the Vermont Medicare ACO Initiative Benchmark in accordance with the terms of this Agreement, except as described in sections 7.c and 9.d. iii. For Performance Year 2 and subsequent Performance Years of the Model, CMS shall execute with VMA ACOs separate Vermont Medicare ACO Initiative participation agreements that are based on the amended participation agreements executed by the Vermont Modified Next Generation ACOs for Performance Year 1. The Vermont Medicare ACO Initiative participation agreements may include additional modifications developed in collaboration with the State to support greater alignment across Scale Target ACO Programs, per section 6.f. GMCB, after consultation with AHS, may propose such modifications to the Initiative, and CMS may accept such proposals for modifications at its sole discretion. iv. CMS will include as part of the Vermont Medicare ACO Initiative the following benefit enhancements: Telehealth, Care Management Home Visits, Post-discharge home visits, and 3-day SNF Rule payment waivers. v. For Performance Year 2 and subsequent Performance Years of the Model, CMS will include the payment mechanism of all-inclusive population- based payments as part of the Vermont Medicare ACO Initiative. vi. CMS shall collaborate with the GMCB to analyze and understand data to inform how Vermont Medicare ACO Initiative Benchmarks are set for Vermont Modified Next Generation ACOs and VMA ACOs. vii. CMS will assess the Vermont Medicare ACO Initiative Benchmarks to ensure consistency with standards set forth in section 8.b.ii.1 and will make a decision on whether to approve the Vermont Medicare ACO Initiative Benchmarks submitted by the GMCB, as discussed in section 8.b.ii.

CMS Duties i. CMS, in collaboration with Vermont, will determine the parameters and requirements of the Initiative, including governance, beneficiary alignment methodology, payment mechanisms, risk arrangements, and benefit enhancements. CMS may exercise its authority to set the Vermont Medicare ACO Initiative Benchmarks as articulated in Sections 5.c and 6.d of this Agreement. ii. For Performance Year 1 of the Model, CMS shall provide Vermont Modified Next Generation ACOs participation agreements that are based on the Next Generation ACO Model participation agreements but are amended to reflect GMCB’s duty to set the Vermont Medicare ACO Initiative Benchmark, except as described in section 5.c and 6.d of this Agreement. iii. For Performance Years 2 through 5 of the Model, CMS shall provide VMA ACOs separate Vermont Medicare ACO Initiative participation agreements that are based on the amended participation agreements offered to the Vermont Modified Next Generation ACOs in Performance Year 1. The Vermont Medicare ACO Initiative participation agreements may include additional modifications developed in collaboration with the State to support greater alignment across Scale Target ACO Programs, per Section 4.f. iv. CMS shall include as part of the Vermont Medicare ACO Initiative benefit enhancements that are also included in the Next Generation ACO Model: Telehealth, Post-discharge home visits, and 3-day SNF Rule waivers. v. CMS shall work with the GMCB throughout the year prior to each Performance Year to analyze and understand data to inform how Vermont Medicare ACO Initiative Benchmarks are set for Vermont Modified Next Generation ACOs and VMA ACOs.