Exogenous Factors. The GMCB, in consultation with AHS where appropriate, may submit, in writing to CMS, a request that exogenous factor(s) (e.g., changes in Medicare law and regulation or Vermont- localized health or economic shocks, the COVID-19 pandemic and resulting disruption to the health care system) be taken into consideration when assessing performance on the All-payer or Medicare Total Cost of Care per Beneficiary Growth Targets. Vermont shall explain the impact of such factors on the Model, including any recommendations as to how CMS should adjust the Model to reflect these exogenous factors. Any such adjustment will be at the sole discretion of CMS.
Exogenous Factors. The GMCB, in consultation with AHS where appropriate, may submit, in writing to CMS, a request that exogenous factor(s) (e.g., changes in Medicare law and regulation, Vermont-localized health or economic shocks, the COVID-19 pandemic and resulting disruption to the health care system) be taken into consideration when assessing performance on the Statewide Health Outcome and Quality of Care Targets. Vermont shall explain the impact of such factors on the Model, including any recommendations as to how CMS should adjust the Model to reflect these exogenous factors, including how performance on the Statewide Health Outcome or Quality of Care Targets should be assessed. Any such adjustment will be at the sole discretion of CMS.
Exogenous Factors. Vermont may submit, in writing to CMS, a request that exogenous factor(s) (e.g., changes in Medicare law and regulation or Vermont-localized health or economic shocks) be taken into consideration when assessing performance on the All- payer and/or Medicare Total Cost of Care per Beneficiary Growth Targets. Vermont shall explain the impact of such factors on the Model, including any recommendations as to how CMS should adjust the Model to reflect these exogenous factors. Any such adjustment will be at the sole discretion of CMS.
Exogenous Factors. CMS may adjust the calculation of a Statewide Accountability Target to take into account any Exogenous Factors.
i. The State may submit to CMS a written request, no later than six (6) months after the end of a given PY in which the State experienced an Exogenous Factor, requesting that CMS adjust a Statewide Accountability Target for that PY due to an Exogenous Factor.
ii. The State’s request must include an explanation of the impact of the Exogenous Factor on the Model and a recommendation as to how CMS should adjust a Statewide Accountability Target due to the Exogenous Factor.
iii. CMS will approve or deny the State’s request within 120 days of receipt of the request.
iv. Any adjustment to a Statewide Accountability Target due to an Exogenous Factor will be made by CMS at CMS’ sole discretion. Such adjustments, if any, would be set forth in separately issued documentation specific to this Agreement and/or an amendment to this Agreement.
Exogenous Factors. Any exogenous factors that impacted hospital revenues
Exogenous Factors. CMS recognizes that Medicare per beneficiary cost increase or cumulative annual all-payer per capita regulated services growth may occur due to factors unrelated to the Model, including changes in Medicare law and regulation. The State may submit, in writing, a request that such exogenous factor(s) be taken into consideration when assessing performance on the All-Payer Ceiling and calculating Medicare savings. Vermont must explain the impact of such factors on Regulated Services and recommend how CMS should adjust the All-Payer Ceiling, Medicare savings, or both to reflect these factors.
Exogenous Factors. In the event (i) that any material amount of the Merchantable Timber is damaged or destroyed by fire or other casualty or (ii) of the imposition of any new or more restrictive Governmental Requirements not accounted for in the most recent appraisal which could materially impact the value of the Merchantable Timber or the ability to harvest the same or (iii) of the termination of any Stumpage Rights, the Borrower shall notify the Administrative Agent and the Administrative Agent shall after consultation with the Borrower and the Acceptable Appraiser, to the extent appropriate, adjust the Value of Merchantable Timber to account for the event which has occurred and notify the Borrower and the Lenders of such adjustment.
