Common use of Prospective Plus Alignment Clause in Contracts

Prospective Plus Alignment. If the ACO has selected Prospective Plus Alignment as the ACO’s Alignment Methodology for a Performance Year as described in Section 8.01: 1. CMS will align a Beneficiary to the ACO via Voluntary Alignment prior to the start of the second through fourth calendar quarters of the Performance Year, to take effect on a date specified by CMS, if a. The Beneficiary has completed a Valid Designation through MVA by a date specified by CMS, or the ACO has submitted to CMS a Valid Designation made by the Beneficiary through SVA by a date and in a manner determined by CMS; b. The Beneficiary is not aligned, assigned, or attributed to another REACH ACO (except as otherwise specified by CMS), an entity participating in another shared savings initiative, or an entity in another model currently tested under the authority of section 1115A of the Act for which beneficiary overlap with the Model is prohibited for the Performance Year; and c. The Beneficiary is otherwise eligible for alignment to the ACO 2. CMS will use Prospective Plus Alignment to calculate quarterly updates to the ACO’s Performance Year Benchmark and to determine the amount of the PCC Payment, TCC Payment, or APO payment the ACO will receive from CMS for each month of the applicable calendar quarter.

Prospective Plus Alignment. If the ACO has selected Prospective Plus Alignment as the ACO’s Alignment Methodology for a Performance Year as described in Section 8.01: 1. CMS will align a Beneficiary to the ACO via Voluntary Alignment prior to the start of the second through fourth calendar quarters of the Performance Year, to take effect on a date specified by CMS, if a. The Beneficiary has completed a Valid Designation through MVA by a date specified by CMS, or the ACO has submitted to CMS a Valid Designation made by the Beneficiary through SVA by a date and in a manner determined by CMS; b. The Beneficiary is not aligned, assigned, or attributed to another REACH ACO (except as otherwise specified by CMS), an entity participating in another shared savings initiative, or an entity in another model currently tested under the authority of section 1115A of the Act for which beneficiary overlap with the Model is prohibited for the Performance Year; and c. The Beneficiary is otherwise eligible for alignment to the ACO. 2. CMS will use Prospective Plus Alignment to calculate quarterly updates to the ACO’s Performance Year Benchmark and to determine the amount of the PCC Payment, TCC Payment, or APO payment the ACO will receive from CMS for each month of the applicable calendar quarter.

Prospective Plus Alignment. If the ACO DCE has selected Prospective Plus Alignment as the ACO’s DCE's Alignment Methodology for a Performance Year as described in Section 8.01: 1. CMS will align a Beneficiary to the ACO DCE via Voluntary Alignment prior to the start of the second through fourth calendar quarters of the Performance Year, to take effect on a date specified by CMS, if: a. The Beneficiary has completed a Valid Designation through MVA Electronic Voluntary Alignment by a date specified by CMS, or the ACO DCE has submitted to CMS a Valid Designation made by the Beneficiary through SVA Paper-Based Voluntary Alignment by a date and in a manner determined by CMS; b. The Beneficiary is not aligned, assigned, or attributed to another REACH ACO Medicare DCE (except as otherwise specified by CMS), an entity participating in another shared savings initiative, or an entity in another model currently tested under the authority of section 1115A of the Act for which beneficiary overlap with the Model is prohibited for the Performance Year; and c. The Beneficiary is otherwise eligible for alignment to the ACODCE. 2. CMS will use Prospective Plus Alignment to calculate quarterly updates to the ACO’s DCE's Performance Year Benchmark and to determine the amount of the PCC Payment, TCC Payment, or APO payment the ACO DCE will receive from CMS for each month of the applicable calendar quarter.

Prospective Plus Alignment. If the ACO DCE has selected Prospective Plus Alignment as the ACODCE’s Alignment Methodology for a Performance Year as described in Section 8.01: 1. A. CMS will align a Beneficiary to the ACO DCE via Voluntary Alignment prior to the start of the second through fourth calendar quarters of the Performance Year, to take effect on a date specified by CMS, if: a. The Beneficiary has completed a Valid Designation through MVA Electronic Voluntary Alignment by a date specified by CMS, or the ACO DCE has submitted to CMS a Valid Designation made by the Beneficiary through SVA Paper-Based Voluntary Alignment by a date and in a manner determined by CMS; b. The Beneficiary is not aligned, assigned, or attributed to another REACH ACO Medicare DCE (except as otherwise specified by CMS), an entity participating in another shared savings initiative, or an entity in another model currently tested under the authority of section 1115A of the Act for which beneficiary overlap with the Model is prohibited for the Performance Year; and c. The Beneficiary is otherwise eligible for alignment to the ACODCE. 2. B. CMS will use Prospective Plus Alignment to calculate quarterly updates to the ACODCE’s Performance Year Benchmark and to determine the amount of the PCC Payment, TCC Payment, or APO payment the ACO DCE will receive from CMS for each month of the applicable calendar quarter.