Second Year Model Testing Pre-Approval Requirements Sample Clauses

Second Year Model Testing Pre-Approval Requirements. The Recipient had to submit an Operational Plan by December 1, 2017. The Recipient agrees to address deficiencies in their Operational Plan as identified by CMMI, provide clarification on specified elements of their Operational Plan, and provide evidence to demonstrate their readiness for the second year of the Model Testing Phase. The submitted evidence should describe how broad-based accountability for outcomes, including total cost of care for Medicare, Medicaid, and CHIP beneficiaries, is created. In addition, submitted evidence for new payment and service delivery models must describe a pathway with specific milestones to move the care in the state for the preponderance of the state’s total population from models that reward service volume to clinical and financial models that reward better health, better care, and lower cost through improvement, and consider levers and strategies that can be applied to influence the structure and performance of the state’s entire health care system, as stated in the FOA. The Recipient must cooperate with CMS and its contractors to ensure that the submitted evidence demonstrates their readiness for the second year of the Model Testing Phase. Specifically, during the second year of the Model Testing Phase the Recipient agrees to submit evidence outlining processes and milestones including, but not limited to, the following areas:

Second Year Model Testing Pre-Approval Requirements. Recipient had to submit a letter of attestation, obligating Recipient to be accountable for: All proposed SIM activities included in CT’s original SIM proposal, as amended (which constitutes the basis for granting the state a SIM R2 award); all components of the state’s SIM R2 Operational Plans from 2015-2017 (continuing to implement and maintain activities outlined in those AY1 and AY2 plans), as amended; completion of all carryover milestones from AY1 and AY2; maintenance of AY1 and AY2 data and activities; and completion of AY3 and AY4 milestones/activities. Recipient further acknowledged in the letter of attestation that the state’s original SIM R2 proposal, operational plans from year 2015-2019 and associated appendices, as amended, constitute Connecticut’s overall 4 year SIM award, and Recipient agreed to implement and maintain relevant activities outlined in those documents (as amended), as well as to cooperate with the independent SIM R2 federal evaluation of Connecticut’s SIM program which spans from 2015 to the end of Connecticut’s SIM award. Recipient had to apply for a transfer of the project, and submit an Operational Plan, prior to the start of the new performance period. The Recipient agrees to address deficiencies in their Operational Plan as identified by CMMI, provide clarification on specified elements of their Operational Plan, and provide evidence to demonstrate their readiness for the second year of the Model Testing Phase. The submitted evidence should describe how broad-based accountability for outcomes, including total cost of care for Medicare, Medicaid, and CHIP beneficiaries, is created. In addition, submitted evidence for new payment and service delivery models must describe a pathway with specific milestones to move the care in the state for the preponderance of the state’s total population from models that reward service volume to clinical and financial models that reward better health, better care, and lower cost through improvement, and consider levers and strategies that can be applied to influence the structure and performance of the state’s entire health care system, as stated in the FOA. The Recipient must cooperate with CMS and its contractors to ensure that the submitted evidence demonstrates their readiness for the second year of the Model Testing Phase. Specifically, during the second year of the Model Testing Phase the Recipient agrees to submit evidence outlining processes and milestones including, but not limited...