Vermont Medicare ACO Initiative definition

Vermont Medicare ACO Initiative or “Initiative” is the ACO initiative that will start in Performance Year 2 of this Model and will be executed under a Vermont Medicare ACO Initiative Participation Agreement, as described in section 8.
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Examples of Vermont Medicare ACO Initiative in a sentence

  • State that participation in the Model may preclude the individual or entity from participating in the Medicare Shared Savings Program, another REACH ACO in the Model, the Vermont Medicare ACO Initiative, the Kidney Care Choices Model, any other Medicare initiative that involves shared savings (except as otherwise specified by CMS), the Primary Care First Model, the Maryland Total Cost of Care Model, and the Independence at Home Demonstration.

  • Together these authorities make it possible for physicians and other clinicians in Vermont to participate the aligned and state-specific Vermont Medicare ACO Initiative and Medicaid ACO initiative.

  • The fourth sentence of Paragraph 2.2 shall be amended to read as follows: Any Participant who is eligible to align or attribute lives may only participate in one ACO Program per Payer, for example if an eligible aligning Participant is in the Vermont Medicare ACO Initiative, it may not be in MSSP.

  • Under the Quality Payment Program, the two-sided risk portion of the Vermont Medicare ACO Initiative meets the criteria to be an Advanced Alternative Payment Model.

  • The State’s plan to improve its performance against the population-level health outcomes target(s) may include, but is not limited to, increasing the State and/or Vermont ACO’s investments into community-based resources and/or increasing the Vermont Medicare ACO Initiative Benchmark’s weight given to ACO quality performance.

  • Any Participant who is eligible to align or attribute lives may only participate in one ACO Program per Payer, for example if an eligible aligning Participant is in Medicare NextGen or Vermont Medicare ACO Initiative, it may not be in MSSP.

  • CMS shall collaborate with the GMCB to analyze and understand data to inform how Vermont Medicare ACO Initiative Benchmarks are set for Vermont Modified Next Generation ACOs and VMA ACOs.

  • For this Model, and consistent with this standard, the Secretary issued on December 20, 2018, a Notice of Waivers of Certain Fraud and Abuse Laws in Connection With the Vermont Medicare ACO Initiative Within the Vermont All-Payer ACO Model (“Notice of Waivers”).

  • Participant warrants that it has the authority to and does bind itself and employees, including each Provider with an NPI number billing under its TIN who is included on the Vermont Medicare ACO Initiative Participant List, to the Agreement and this Program Addendum.

  • Under the Agreement, the Centers for Medicare and Medicaid Services (CMS), in collaboration with the State of Vermont, will launch the Vermont Medicare ACO Initiative, which will begin on January 1, 2019.

Related to Vermont Medicare ACO Initiative

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Pharmacy benefits management means the administration or management of prescription drug

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • CMS means the Centers for Medicare and Medicaid Services.

  • Health care corporation means a health care corporation incorporated under the nonprofit health care corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1704.

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Child Care Program means a person or business that offers child care.

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Health care entity means any health care provider, health plan or health care clearinghouse.

  • Pharmacy care means medications prescribed by a licensed physician and any health-related services considered medically necessary to determine the need or effectiveness of the medications.

  • Health plan or "health benefit plan" means any policy,

  • Community mental health program means all mental health

  • Foster care services means the provision of a full range of casework, treatment and community

  • Nursing Care Plan means a plan of care developed by a nurse that describes the medical, nursing, psychosocial, and other needs of a child and how those needs shall be met. The Nursing Care Plan includes which tasks shall be taught, assigned, or delegated to the qualified provider or family.

  • Asset Management Plan means a strategic document that states how a group of assets are to be managed over a period of time. The plan describes the characteristics and condition of infrastructure assets, the levels of service expected from them, planned actions to ensure the assets are providing the expected level of service, and financing strategies to implement the planned actions. The plan may use any appropriate format, as long as it includes the information and analysis required to be in a plan as described in Ontario’s Building Together: Guide for Asset Management Plans.

  • Adult foster care means room and board, supervision, and special services to an adult who has a

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Medical flexible spending arrangement or "medical FSA" means a benefit plan whereby eligible state employees may reduce their salary before taxes to pay for medical expenses not reimbursed by insurance as provided in the salary reduction plan established under chapter

  • Medical cannabis card means the same as that term is defined in Section 26-61a-102.

  • Hospice means a public agency or private organization licensed pursuant to Chapter 400, Florida Statutes, to provide Hospice services. Such licensed entity must be principally engaged in providing pain relief, symptom management, and supportive services to terminally ill Members and their families.

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.