Model Testing Phase Requirements Sample Clauses

Model Testing Phase Requirements. The Recipient will not begin the second year of the Model Testing Phase until they have addressed specific deficiencies in their Operational Plan and/or met specific milestones. Award of this cooperative agreement does not relieve the Recipient from the obligation to consider strategies beyond those delineated in the recipient’s application.

Model Testing Phase Requirements. The Recipient will not transition to the first year of the Model Testing Phase until they have addressed specific deficiencies in their Operational Plan and/or met specific milestones Award of this cooperative agreement does not relieve the Recipient from the obligation to consider strategies beyond those delineated in the recipient’s application. During the project period, the Recipient and state government stakeholders must: a. Implement and test a State Health Care Innovation Plan, encompassing the payment and services delivery models included within the Plan, which meets the requirements for Model Test as specified in the FOA. In addition, the Recipient is expected to perform rapid-cycle evaluation and adjust the State Health Care Innovation Plan according to evaluation findings and with reference to the Model Test requirements. b. Use Model Testing funds to produce better health, better care, and lower cost through improvement for Medicare (which may involve new or modified payment models), Medicaid, and/or CHIP beneficiaries. Specifically, the funds must be used to implement new payment and service delivery models that will support these outcomes. c. Expend no SIM funds in the following areas which are out of the scope of the State Innovation Models initiative: • Medicare eligibility changes; • Coverage or benefits reductions in Medicare or Medicaid or any changes that would have the effect of rationing care; • Increases in premiums or cost sharing; • Increases in net federal spending under the Medicare, Medicaid or CHIP programs; • Medicaid Federal Medical Assistance Percentage formula changes; • Changes to the EHR incentive program for eligible professionals and eligible hospitals; • Changes in State Financial Alignment Models; • Reductions in Medicare beneficiary choice of provider or health plan, or Medicaid choice of provider or health plan beyond those allowed today; or changes to maintenance of effort requirements; • Changes to CMS sanctions, penalties, or official denial of participation currently in effect. d. Utilize policy, regulatory, or legislative based activities or authorities to support the goals of the model, to include authorities both within and outside of the state’s health department(s). e. Deliver broad-based accountability for high value outcomes and include multi-payer alignment.