Threshold Penalty Sample Clauses

Threshold Penalty. Hospitals that do not score above the 9th decile threshold (Year 2) in any clinical area will receive a 1% reduction of their Medicare payment in that clinical area for Year 4; hospitals that do not score above the 10th decile threshold in any clinical areas (Year 2) will receive a 2% reduction of their Medicare payment in that clinical area for Year 4. The same will occur in Year 5 with the penalty based on Year 3 decile thresholds and for Year 6 with the penalty based on Year 4 decile thresholds. Incentive payment amounts will be based on the number of cases identified by CMS as being Medicare fee-for-service beneficiaries who received care within the applicable demonstration year in one of the clinical area(s) as determined by the applicable principal diagnosis or principal procedure code. The payment methodology may be modified in Years 5 and 6 to enable CMS to evaluate alternative incentive models. CMS has budgeted $12 million per year for demonstration incentives. The availability and amount of payment incentives will be based on the approval by CMS. Incentive payments will be made annually in a lump sum. Measures used to calculate the incentive payment will not include any test measures.