Vermont ACO definition

Vermont ACO means an ACO primarily operating in Vermont that has contracts with any of the following payers: Vermont Medicaid, Vermont Commercial Plans; Vermont Self-insured Plans; or Medicare under the Medicare Shared Savings Program, the Next Generation ACO Model, or the Vermont Medicare ACO Initiative.
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Examples of Vermont ACO in a sentence

  • The GMCB shall ensure that a Vermont ACO shall not interfere with a patient’s choice of health care providers under the patient’s health plan, regardless of whether a provider is participating in the ACO.

  • In order for a Vermont ACO to be eligible to participate in the Vermont Medicare ACO Initiative or be eligible to become a Vermont Modified Next Generation ACO, the GMCB must submit to CMS a letter jointly signed by the GMCB and the Vermont ACO attesting that the two entities will work together to achieve the ACO Scale Targets, Statewide Financial Targets, and Statewide Health Outcomes and Quality of Care Targets of the Vermont All-payer ACO Model.

  • The State shall submit by June 30th of Performance Year 3 a plan signed by Vermont’s Department of Health, AHS, the GMCB, and Vermont ACO(s) that provides an accountability framework to the public health system to ensure that any Vermont ACO funding allocated to community health services is being used towards achieving the Statewide Health Outcomes and Quality of Care Targets.

  • The GMCB and the Vermont ACO shall submit the letter in a manner and by a deadline determined by CMS.

  • To some extent, it may even be argued that the very reason for developing models is the need to be able to convert discrete observations of parameters (or their proxies) in a continuous model.

  • CMS provides no opinion on the legality of any contractual or financial arrangement that the State or a Vermont ACO has proposed, implemented or documented.

  • There has been a termination, dispute or allegation of fraud or similar fault against the State or a Vermont ACO or other individuals or entities performing functions or services related to the Model, in which case the records shall be maintained for an additional six years from the date of any resulting final resolution of the termination, dispute, or allegation of fraud or similar fault.

  • If a healthcare payer has covered services that are excluded by other payers, the Vermont ACO may have a broader network of providers for that payer to ensure beneficiaries have full access to covered services.

  • If any Vermont ACO does not have a single network of providers for All- payer Financial Target Services regardless of payer by the beginning of Performance Year 2, then AHS shall require the Vermont ACO, as a condition of its Medicaid contract, to ensure that at least 90 percent of all providers in the Vermont ACO’s network accept Vermont Medicaid beneficiaries.

  • In its CAP, the State shall address all actions the State and/or Vermont ACO will take to correct any deficiencies and remain in compliance with the Agreement.

Related to Vermont ACO

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  • Public Finance Management Act ’ means the Public Finance Management Act, 1999 (Act No. 1 of 1999);

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  • Title IV-E Foster Care means a federal program authorized under §§ 472 and 473 of the Social

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