Interactions with Non-SSI Innovation Center Initiatives Sample Clauses

Interactions with Non-SSI Innovation Center Initiatives. In the event that a Participant or, as applicable, a Downstream Episode Initiator is also participating in an Innovation Center model implemented via regulation (e.g., the Comprehensive Care for Joint Replacement (CJR) Model), the Participant will not be permitted to select clinical episodes included in those models under BPCI Advanced. For example, all episodes included in CJR will be excluded from Reconciliation under BPCI Advanced. Furthermore, in the event the Participant is located in one or more Metropolitan Statistical Areas included in an Innovation Center model implemented via regulation (e.g., the CJR Model), CMS will exclude from the BPCI Advanced Reconciliation calculation all Clinical Episodes included in that model. In the event that a Participant or, as applicable, an Episode Initiator participating in BPCI Advanced pursuant to an agreement with the Participant is also a participant in the Oncology Care Model (OCM), BPCI Advanced Clinical Episodes and OCM Episodes will run concurrently. In the event a BPCI Advanced Clinical Episode overlaps with one or more OCM Episodes, CMS will adjust the OCM performance-based payments to account for the BPCI Advanced NPRA or Repayment Amount, prorated based on the proportion of the BPCI Advanced Clinical Episode that overlaps with the OCM Episode. In the event of overlap with a future episode-based model (other than a model implemented via regulation, as described above), CMS will, in CMS’s sole discretion and without the consent of the Participant, update this Appendix A to reflect the methodology that will be used to adjust the BPCI Advanced NPRA or Repayment Amount. To the extent practicable, CMS will notify the Participant of any such methodology at least 90 Days in advance of the effective date thereof.
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Related to Interactions with Non-SSI Innovation Center Initiatives

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