Influencing or Attempting to Influence the Beneficiary. 1. The ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities to not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form or a XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site designation, including but not limited to the following: a. Completing a Voluntary Alignment Form on behalf of the Beneficiary; b. Designating a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site on behalf of the Beneficiary; c. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and d. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care. 2. The ACO may instruct its Participant Providers and Preferred Providers to answer questions from Beneficiaries regarding Voluntary Alignment, but must prohibit Participant Providers and Preferred Providers from completing a Voluntary Alignment Form or designating a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site on behalf of the Beneficiary. 3. The ACO shall require its Participant Providers and Preferred Providers to instruct Beneficiaries to call the ACO for questions about how to make changes to a Voluntary Alignment Form or how to designate a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site. 4. CMS will provide the ACO with information on how a Beneficiary may designate a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site as his or her primary clinician for purposes of MVA. If the ACO, a Participant Provider, or a Preferred Provider chooses to share this information with Beneficiaries, the sharing of this information would be considered a Voluntary Alignment Activity subject to the requirements of Section 5.04. 5. Failure to comply with the requirements of this Article V and, if the ACO has selected to participate in SVA, the requirements of Appendix C of the Agreement, may result in retroactive reversal of any alignment of Beneficiaries to the ACO that occurred solely pursuant to Voluntary Alignment, to include via Prospective Plus Alignment.
Appears in 3 contracts
Samples: Participation Agreement, Participation Agreement, Model Performance Period Participation Agreement
Influencing or Attempting to Influence the Beneficiary. 1. The ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities to not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form or a XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site designation, including but not limited to the following:
a. Completing a Voluntary Alignment Form on behalf of the Beneficiary;
b. Designating a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site on behalf of the Beneficiary;
c. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and
d. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care.
2. The ACO may instruct its Participant Providers and Preferred Providers to answer questions from Beneficiaries regarding Voluntary Alignment, but must prohibit Participant Providers and Preferred Providers from completing a Voluntary Alignment Form or designating a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site on behalf of the Beneficiary.
3. The ACO shall require its Participant Providers and Preferred Providers to instruct Beneficiaries to call the ACO for questions about how to make changes to a Voluntary Alignment Form or how to designate a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site.
4. CMS will provide the ACO with information on how a Beneficiary may designate a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site as his or her primary clinician for purposes of MVA. If the ACO, a Participant Provider, or a Preferred Provider chooses to share this information with Beneficiaries, the sharing of this information would be considered a Voluntary Alignment Activity subject to the requirements of Section 5.04.
5. Failure to comply with the requirements of this Article V and, if the ACO has selected to participate in SVA, the requirements of Appendix C of the Agreement, may result in retroactive reversal of any alignment of Beneficiaries to the ACO that occurred solely pursuant to Voluntary Alignment, to include via Prospective Plus Alignment.
Appears in 3 contracts
Samples: Participation Agreement, Participation Agreement, Participation Agreement
Influencing or Attempting to Influence the Beneficiary. 1. The ACO DCE shall not, and shall require its DC Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO DCE Activities or Marketing Activities to not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form or a XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) designation, including but not limited to the following:
a. Completing a Voluntary Alignment Form on behalf of the Beneficiary;
b. Designating a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) on behalf of the Beneficiary;
c. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and
d. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care.
2. The ACO DCE may instruct its DC Participant Providers and Preferred Providers to answer questions from Beneficiaries regarding Voluntary Alignment, but must prohibit DC Participant Providers and Preferred Providers from completing a Voluntary Alignment Form or designating a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) on behalf of the Beneficiary.
3. The ACO DCE shall require its DC Participant Providers and Preferred Providers to instruct Beneficiaries to call the ACO DCE for questions about how to make changes to a Voluntary Alignment Form or how to designate a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site).
4. CMS will provide the ACO DCE with information on how a Beneficiary may designate a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) as his or her primary clinician for purposes of MVA. If the ACO, a Participant Provider, or a Preferred Provider chooses to share this information with Beneficiaries, the sharing of this information would be considered a Voluntary Alignment Activity subject to the requirements of Section 5.04.
5. Failure to comply with the requirements of this Article V and, if the ACO has selected to participate in SVA, the requirements of Appendix C of the Agreement, may result in retroactive reversal of any alignment of Beneficiaries to the ACO that occurred solely pursuant to Voluntary Alignment, to include via Prospective Plus Alignment.of
Appears in 1 contract
Samples: Global and Professional Direct Contracting Model Performance Period Participation Agreement
Influencing or Attempting to Influence the Beneficiary. 1. The ACO DCE shall not, and shall require its DC Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO DCE Activities or Marketing Activities to not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s 's decision to complete or not complete a Voluntary Alignment Form or a XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) designation, including but not limited to the following:
a. Completing a Voluntary Alignment Form on behalf of the Beneficiary;
b. Designating a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) on behalf of the Beneficiary;
c. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and
d. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care.
2. The ACO DCE may instruct its DC Participant Providers and Preferred Providers to answer questions from Beneficiaries regarding Voluntary Alignment, but must prohibit DC Participant Providers and Preferred Providers from completing a Voluntary Alignment Form or designating a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site site) on behalf of the Beneficiary.
3. The ACO DCE shall require its DC Participant Providers and Preferred Providers to instruct Beneficiaries to call the ACO DCE for questions about how to make changes to a Voluntary Alignment Form or how to designate a primary clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, XxXxxxxxxx.xxx (or any successor site).
4. CMS will provide the ACO with information on how a Beneficiary may designate a clinician on XxXxxxxxxx.xxx, Xxxxxxxx.xxx, or any successor site as his or her primary clinician for purposes of MVA. If the ACO, a Participant Provider, or a Preferred Provider chooses to share this information with Beneficiaries, the sharing of this information would be considered a Voluntary Alignment Activity subject to the requirements of Section 5.04.
5. Failure to comply with the requirements of this Article V and, if the ACO has selected to participate in SVA, the requirements of Appendix C of the Agreement, may result in retroactive reversal of any alignment of Beneficiaries to the ACO that occurred solely pursuant to Voluntary Alignment, to include via Prospective Plus Alignment.
Appears in 1 contract
Samples: Global and Professional Direct Contracting Model Participation Agreement
