Post-Episode Spending Calculation Sample Clauses

Post-Episode Spending Calculation. The Post-Episode Spending Calculation will be performed by CMS on a semi-annual basis during the first true-up Reconciliation. A preliminary Episode Initiator-specific benchmark price for the Post-Episode Spending Monitoring Period will be calculated in the same manner as for the Episode Initiator-specific Target Prices calculated for each Clinical Episode, as described above. If the total dollar amount of Medicare Fee-for-Service (FFS) expenditures for items and services furnished to a BPCI Advanced Beneficiary during the 30-Day Post-Episode Monitoring Period exceeds that benchmark price by a risk threshold, based on a 99.5 percent confidence interval around the expected spending the Post-Episode Spending Monitoring Period, the result would be an Excess Spending Amount that must be repaid to CMS in accordance with Article 7 of the Agreement.
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Related to Post-Episode Spending Calculation

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