Common use of Initial Preferred Provider List Clause in Contracts

Initial Preferred Provider List. ‌ 1. The parties acknowledge that the ACO submitted to CMS a proposed list of Preferred Providers identified by name, NPI, TIN, CCN (if applicable), and Legacy TIN or CCN (if applicable). The proposed list also identified which individuals and entities, if any, had agreed to receive a PBP Fee Reduction or AIPBP Fee Reduction, and specified the Benefit Enhancements, if any, in which each individual or entity had agreed to participate. 2. CMS states that it will review the proposed list of Preferred Providers and conduct a program integrity screening on the proposed Preferred Providers. 3. Before the Start Date, CMS will submit to the ACO a list of individuals and entities that it has approved to be Preferred Providers. The ACO shall review the list and make any necessary corrections to it, including the removal of any individuals or entities that have not agreed to participate in the Model as of the Start Date pursuant to a written agreement. No additions to this list are permitted at this time. 4. Before the Start Date, or at such other time as may be specified by CMS, the ACO shall submit to CMS an initial Preferred Provider List that the ACO has certified is a true, accurate, and complete list identifying the following: (i) all of the ACO’s Preferred Providers approved by CMS to participate in the Model as of the Start Date, and with whom the ACO will have a fully executed written agreement meeting the requirements in Section III.D.6; (ii) each Preferred Provider, if any, that has agreed to receive a PBP Fee Reduction, or AIPBP Fee Reduction; and

Initial Preferred Provider List. ‌ 1. The parties acknowledge that the ACO submitted to CMS a proposed list of Preferred Providers identified by name, NPI, TIN, Legacy TIN or CCN (if applicable), and Legacy TIN or CCN (if applicable). The proposed list also identified which individuals and entities, if any, had agreed to receive a PBP Fee Reduction or an AIPBP Fee Reduction, and specified the Benefit Enhancements, if any, in which each individual or entity had agreed to participate. 2. CMS states that it will review the proposed list of Preferred Providers and conduct a program integrity screening on the proposed Preferred Providers. 3. Before the Start Date, CMS will submit to the ACO a list of individuals and entities that it has approved to be Preferred Providers. The ACO shall review the list and make any necessary corrections to it, including the removal of any individuals or entities that have not agreed to participate in the Model as of the Start Date pursuant to a written agreement. No additions to this list are permitted at this time. 4. Before the Start Date, or at such other time as may be specified by CMS, the ACO shall submit to CMS an initial Preferred Provider List that the ACO has certified is a true, accurate, and complete list identifying the following: (i) all of the ACO’s Preferred Providers approved by CMS to participate in the Model as of the Start Date, and with whom the ACO will have a fully executed written agreement meeting the requirements in Section III.D.6; (ii) each Preferred Provider, if any, that has agreed to receive a PBP Fee Reduction, or an AIPBP Fee Reduction; andand (iii) the specific Benefit Enhancements, if any, in which each Preferred Provider has agreed to participate. 5. The ACO shall update the initial Preferred Provider List in accordance with Section IV.D.

Initial Preferred Provider List. ‌ 1. The parties acknowledge that the ACO submitted to CMS a proposed list of Preferred Providers identified by name, NPI, TIN, CCN (if applicable), and Legacy TIN or CCN (if applicable). The proposed list also identified which individuals and entities, if any, had agreed to receive a PBP Fee Reduction or AIPBP Fee Reduction, and specified the Benefit Enhancements, if any, in which each individual or entity had agreed to participate. 2. CMS states that it will review the proposed list of Preferred Providers and conduct a program integrity screening on the proposed Preferred Providers. 3. Before the Start Date, CMS will shall submit to the ACO a list of individuals and entities that it has approved to be Preferred Providers. The ACO shall review the list and make any necessary corrections to it, including the removal of any individuals or entities that have not agreed to participate in the Model as of the Start Date pursuant to a written agreementModel. No additions to this list are permitted at this time. 4. Before the Start Date, Date or at such other time as may be specified by CMS, the ACO shall submit to CMS an initial Preferred Provider List that the ACO has certified is a true, accurate, accurate and complete list identifying the following: (i) all of the ACO’s Preferred Providers approved by CMS to participate in the Model as of the Start Date, and with whom the ACO will have have, by the date specified in Section III.D.7.a, a fully executed written agreement meeting the requirements in Section III.D.6; (ii) each Preferred Provider, if any, Provider that has agreed to receive a PBP Fee Reduction, or AIPBP Fee Reduction; and, if applicable, and (iii) the specific Benefit Enhancements, if any, in which each Preferred Provider has agreed to participate. 5. The ACO shall update the initial Preferred Provider List in accordance with Sections IV.D and IV.E.