REACH Beneficiary definition

REACH Beneficiary means a Beneficiary who is aligned to the ACO using the methodology set forth in Appendix A of the Agreement and who has not subsequently been excluded from the aligned population of the ACO.
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Examples of REACH Beneficiary in a sentence

  • This prohibition shall not apply to referrals made by employees or contractors who are operating within the scope of their employment or contractual arrangement with the employer or contracting entity, provided that the employees and contractors remain free to make referrals without restriction or limitation if a REACH Beneficiary expresses a preference for a different provider or supplier, or the referral is not in the REACH Beneficiary's best medical interests in the judgment of the referring party.

  • The ACO may affirmatively contact a REACH Beneficiary who has elected to decline claims data sharing no more than one time during a Performance Year to provide information regarding data sharing.

  • In conducting the collection required under this Section 13.01.D, the ACO shall make a reasonable effort to collect demographic and social determinants of health data from all REACH Beneficiaries but, in the case of a REACH Beneficiary that elects not to provide such data to the ACO, its Participant Providers, or its Preferred Providers, the ACO shall indicate such election by the REACH Beneficiary in its report to CMS.