Benefit Enhancements definition

Benefit Enhancements means the following enhanced benefits the ACO may choose to make available to REACH Beneficiaries through Participant Providers and Preferred Providers in order to support high-value services and allow the ACO to more effectively manage the care of REACH Beneficiaries: the 3-Day SNF Rule Waiver Benefit Enhancement, the Telehealth Benefit Enhancement, the Post-Discharge Home Visits Benefit Enhancement, the Care Management Home Visits Benefit Enhancement, the Home Health Homebound Waiver Benefit Enhancement, the Concurrent Care for Beneficiaries that Elect Medicare Hospice Benefit Enhancement, and the Nurse Practitioner and Physician Assistant Services Benefit Enhancement. The ACO may select one or more Benefit Enhancements for each Performance Year as described in Section 8.01.

Benefit Enhancements means the following additional benefits the ACO chooses to make available to Next Generation Beneficiaries through Next Generation Participants and Preferred Providers in order to support high-value services and allow the ACO to more effectively manage the care of Next Generation Beneficiaries: (1) 3-Day SNF Rule Waiver Benefit Enhancement (as described in Section XI.B and Appendix I); (2) Telehealth Expansion Benefit Enhancement (as described in Section XI.C and Appendix J); and (3) Post-Discharge Home Visits Benefit Enhancement (as described in Section XI.D and Appendix K).

Benefit Enhancements means the following enhanced benefits the DCE may choose to make available to DC Beneficiaries through DC Participant Providers and Preferred Providers in order to support high-value services and allow the DCE to more effectively manage the care of DC Beneficiaries: the 3-Day SNF Rule Waiver Benefit Enhancement, the Telehealth Benefit Enhancement, the Post-Discharge Home Visits Benefit Enhancement, the Care Management Home Visits Benefit Enhancement, the Home Health Homebound Waiver Benefit Enhancement, and the Concurrent Care for Beneficiaries that Elect Medicare Hospice Benefit Enhancement. The DCE may select one or more Benefit Enhancements for each Performance Year as described in Section 8.01.

Examples of Benefit Enhancements in a sentence

• CMS may require the ACO to report data on the use of Benefit Enhancements and Beneficiary Engagement Incentives to CMS.

• For purposes of furnishing Benefit Enhancements and participating in the ACO’s selected Capitation Payment Mechanism, the removal of an individual or entity from the Participant Provider List or Preferred Provider List will be effective on the last day of the month the individual or entity ceases to meet the requirements of Section 4.01.A(1)-(5) or Section 4.01.B(1)-(5), as applicable.

• The ACO may select as described in Section 8.01 to provide one or more Benefit Enhancements and Beneficiary Engagement Incentives for a Performance Year.

• The ACO shall ensure that any Participant Provider or Preferred Provider that has been terminated pursuant to Sections 4.01.F or 17.01, or has been removed from the Participant Provider List or Preferred Provider List pursuant to Section 4.03.B, as applicable, does not engage in any ACO Activities, Marketing Activities, Voluntary Alignment Activities, Benefit Enhancements, or Beneficiary Engagement Incentives after the effective date of such termination.

More Definitions of Benefit Enhancements

Benefit Enhancements means as the Actuarial Present Value of Total Projected Benefits attributed to the estimated increase in the benefits of

Benefit Enhancements means the following enhanced benefits the DCE may choose to make available to DC Beneficiaries through DC Participant Providers and Preferred Providers in order to support high-value services and allow the DCE to more effectively manage the care of DC Beneficiaries: the 3-Day SNF Rule Waiver Benefit Enhancement, the Telehealth Benefit Enhancement, the Post-Discharge Home Visits Benefit Enhancement, the Care Management Home Visits Benefit Enhancement, the Home Health Homebound Waiver Benefit Enhancement, and the Concurrent Care for Beneficiaries that Elect Medicare Hospice Benefit Enhancement.The DCE may select one or more Benefit Enhancements for each Performance Year as described in Section 8.01.

Benefit Enhancements means the following Plan benefit enhancements, unless adjusted consistent with the terms of the exemption:

Benefit Enhancements means the following additional benefits the ACO chooses to make available to Next Generation Beneficiaries through Next Generation Participants and Preferred Providers in order to support high-value services and allow the ACO to more effectively manage the care of Next Generation Beneficiaries: (1) 3-Day SNF Rule Waiver (as described in Section