Common use of Financial and Payment Model Authorities Clause in Contracts

Financial and Payment Model Authorities. Section 1115A(b)(2) of the Act requires the Secretary of Health and Human Services (“Secretary”) to select models to be tested where the Secretary determines that there is evidence that the model addresses a defined population for which there are deficits in care leading to poor clinical outcomes or potentially avoidable expenditures. The statute provides a non-exhaustive list of examples of models that the Secretary may select that includes, “[a]llowing States to test and evaluate systems of all-payer payment reform for the medical care of residents of the State, including dual eligible individuals.”

Financial and Payment Model Authorities. Section 1115A(b)(2) of the Act requires the Secretary of Health and Human Services (“Secretary”) to select models to be tested where the Secretary determines that there is evidence that the model addresses a defined population for which there are deficits in care leading to poor clinical outcomes or potentially avoidable expenditures. The statute provides a non-exhaustive list of examples of models that the Secretary may select that includesincluding, “[a]llowing States to test and evaluate systems of all-payer payment reform for the medical care of residents of the State, including dual eligible individuals.”