(ACO) regulations - American Society of Anesthesiologists

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CMS-1345-P 228 and patients and their families. As such, we have proposed distinct domains and categories of quality measures, and different frameworks for rewarding performance, under each Affordable Care Act program as illustrated in Table 5. Table 5: Quality Frameworks for Affordable Care Act Programs Domain Proposed for Medicare Shared Savings Program: Accountable Care Organizations Patient/Caregiver Experience Care Coordination Patient Safety Preventive Health At-Risk Population/Frail Elderly Health Proposed for Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults Prevention and health promotion Management of Acute Conditions Management of Chronic Conditions Family Experiences of Care Availability Proposed for Hospital Inpatient Value-Based Purchasing Program Process Measures Outcome Measures Survey Measures National Health Care Quality Strategy and Plan Patient-centeredness and family engagement Eliminating disparities in care Better care Affordable care Healthy communities While these quality domains and categories – and the parties that they affect – overlap in a number of areas, each set of standards has different domains, categories, and specific measures. We recognize that different quality frameworks and rewards may add to confusion and administrative burdens for affected parties, and mitigate efforts to focus on the highest-quality care. We seek comment from affected parties and other stakeholders on the best and most appropriate way to align quality domains, categories, specific measures, and rewards across these and other Federal healthcare programs, to ensure the highest-possible quality of care.
CMS-1345-P 229 Specifically, we seek comment on whether quality standards in different Affordable Care Act programs should use the same definition of domains, categories, specific measures, and rewards for performance across all programs to the greatest extent possible, taking into account meaningful differences in affected parties.
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DEPARTMENT OF HEALTH AND HUMAN SERV
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CMS-1345-P 3 Centers for Medicare &
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CMS-1345-P 5 C. Overview and Intent
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CMS-1345-P 7 7. Aligning ACO Qualit
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CMS-1345-P 9 CCNC Community Care of
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CMS-1345-P 11 SSN TIN Social Securi
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CMS-1345-P 13 better coordinate car
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CMS-1345-P 15 and efficient service
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CMS-1345-P 17 ACO shall have at lea
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CMS-1345-P 19 program or demonstrat
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CMS-1345-P 21 Section 1899(d)(3) of
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CMS-1345-P 23 Section 1899 (i) of t
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CMS-1345-P 25 • An ACO will manag
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CMS-1345-P 27 providers participati
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CMS-1345-P 29 The Affordable Care A
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CMS-1345-P 31 establish an estimate
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CMS-1345-P 33 personal physicians;
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CMS-1345-P 35 • Experience with n
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CMS-1345-P 37 when looking at the e
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CMS-1345-P 39 Medicare FFS benefici
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CMS-1345-P 41 by only those ACO par
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CMS-1345-P 43 Since the statute req
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CMS-1345-P 45 For FQHCs and RHCs, t
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CMS-1345-P 47 individual practition
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CMS-1345-P 49 additional Medicare e
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CMS-1345-P 51 The ACO's legal entit
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CMS-1345-P 53 We note that by propo
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CMS-1345-P 55 and administrative sy
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CMS-1345-P 57 governance would crea
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CMS-1345-P 59 demonstration, partic
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CMS-1345-P 61 We believe that these
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CMS-1345-P 63 • Clinical manageme
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CMS-1345-P 65 participants and ACO
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CMS-1345-P 67 Section 1899(b)(2)(A)
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CMS-1345-P 69 be subject to the req
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CMS-1345-P 71 program while still f
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CMS-1345-P 73 Thus, we considered w
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CMS-1345-P 75 addressing situations
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CMS-1345-P 77 include provisions fo
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CMS-1345-P 79 b. Processes to Promo
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CMS-1345-P 81 • Telehealth. • T
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CMS-1345-P 83 centeredness that is
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CMS-1345-P 85 mechanism for coordin
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CMS-1345-P 87 We are soliciting com
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CMS-1345-P 89 to ensure that survey
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CMS-1345-P 91 panel. Such a proposa
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CMS-1345-P 93 addressing disparitie
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CMS-1345-P 95 Individualized plans
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CMS-1345-P 97 beneficiaries by mini
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CMS-1345-P 99 a. Compliance Plans W
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CMS-1345-P 101 generated by ACO par
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CMS-1345-P 103 C. Establishing the
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CMS-1345-P 105 After evaluating the
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CMS-1345-P 107 when the final payme
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CMS-1345-P 109 performance of ACO p
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CMS-1345-P 111 cost-effectiveness o
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CMS-1345-P 113 they identify priori
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CMS-1345-P 115 generally bars the d
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CMS-1345-P 117 acting on behalf of
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CMS-1345-P 119 previous year's hist
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CMS-1345-P 121 providers/suppliers.
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CMS-1345-P 123 permitted under the
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CMS-1345-P 125 and the claim paymen
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CMS-1345-P 127 measurement activiti
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CMS-1345-P 129 beneficiary choice:
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CMS-1345-P 131 promote trust and pe
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CMS-1345-P 133 beneficiaries. We an
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CMS-1345-P 135 ensure that ACOs und
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CMS-1345-P 137 eligibility since th
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CMS-1345-P 139 or to providers or s
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CMS-1345-P 141 ACO and the eligibil
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CMS-1345-P 143 From a technical, op
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CMS-1345-P 145 beneficiaries would
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CMS-1345-P 147 associated with thos
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CMS-1345-P 149 pediatric medicine,"
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CMS-1345-P 151 care services" on th
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CMS-1345-P 153 better address the d
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CMS-1345-P 155 assignment from year
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CMS-1345-P 157 appropriate safeguar
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CMS-1345-P 159 ACO only when he or
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CMS-1345-P 161 We propose to implem
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CMS-1345-P 163 quality and shared s
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CMS-1345-P 165 chosen. We seek comm
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CMS-1345-P 167 measures to assess t
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CMS-1345-P 169 • To the extent pr
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CMS-1345-P 171 data collection and
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CMS-1345-P 173 improving ACO qualit
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CMS-1345-P 175 Domain Measure Title
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Page 187 and 188: CMS-1345-P 187 43. At Risk Populati
Page 189 and 190: CMS-1345-P 189 50. At Risk Populati
Page 195 and 196: CMS-1345-P 195 Information on Physi
Page 197 and 198: CMS-1345-P 197 associated with clai
Page 199 and 200: CMS-1345-P 199 be required to popul
Page 201 and 202: CMS-1345-P 201 as that term is defi
Page 203 and 204: CMS-1345-P 203 Table 2: Five Measur
Page 205 and 206: CMS-1345-P 205 sided shared savings
Page 207 and 208: CMS-1345-P 207 Table 4: Total Point
Page 209 and 210: CMS-1345-P 209 Medicare program. Fu
Page 211 and 212: CMS-1345-P 211 for the first perfor
Page 213 and 214: CMS-1345-P 213 of quality acknowled
Page 215 and 216: CMS-1345-P 215 (Option 1) but using
Page 217 and 218: CMS-1345-P 217 ACO would qualify fo
Page 219 and 220: CMS-1345-P 219 future rulemaking. W
Page 221 and 222: CMS-1345-P 221 proposing greater al
Page 223 and 224: CMS-1345-P 223 6. Public Reporting
Page 225 and 226: CMS-1345-P 225 efficiency, effectiv
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Page 231 and 232: CMS-1345-P 231 We considered severa
Page 233 and 234: CMS-1345-P 233 Track 2: More experi
Page 235 and 236: CMS-1345-P 235 determinations about
Page 237 and 238: CMS-1345-P 237 beneficiaries during
Page 239 and 240: CMS-1345-P 239 truncate an assigned
Page 241 and 242: CMS-1345-P 241 the demonstration wh
Page 243 and 244: CMS-1345-P 243 We seek comments abo
Page 245 and 246: CMS-1345-P 245 Of these two methods
Page 247 and 248: CMS-1345-P 247 other factor could b
Page 249 and 250: CMS-1345-P 249 Capitation Rates, Pa
Page 251 and 252: CMS-1345-P 251 A model that uses be
Page 253 and 254: CMS-1345-P 253 option to audit ACOs
Page 255 and 256: CMS-1345-P 255 Thus, we are not pro
Page 257 and 258: CMS-1345-P 257 subsequently receive
Page 259 and 260: CMS-1345-P 259 This benchmark is su
Page 261 and 262: CMS-1345-P 261 nationwide under the
Page 263 and 264: CMS-1345-P 263 benchmark based on t
Page 265 and 266: CMS-1345-P 265 upon the number of M
Page 267 and 268: CMS-1345-P 267 beneficiaries. In re
Page 269 and 270: CMS-1345-P 269 and share in savings
Page 271 and 272: CMS-1345-P 271 a result of normal y
Page 273 and 274: CMS-1345-P 273 • 50 percent or mo
Page 275 and 276: CMS-1345-P 275 • Among older adul
Page 277 and 278: CMS-1345-P 277 of dual eligible ben
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CMS-1345-P 279 they incur shareable
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CMS-1345-P 281 for the Medicare pro
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CMS-1345-P 283 and efficiency of ca
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CMS-1345-P 285 have also suggested
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CMS-1345-P 287 providers' willingne
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CMS-1345-P 289 expect to consider i
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CMS-1345-P 291 two years under the
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CMS-1345-P 293 Design Element Minim
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CMS-1345-P 295 performance) under t
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CMS-1345-P 297 For purposes of the
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CMS-1345-P 299 proposed that for th
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CMS-1345-P 301 For example, a two-s
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CMS-1345-P 303 depends on the ACO's
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CMS-1345-P 305 have solicited comme
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CMS-1345-P 307 the ACO's repayment
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CMS-1345-P 309 the growth in Medica
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CMS-1345-P 311 relied upon by us in
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CMS-1345-P 313 requirements not set
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CMS-1345-P 315 entity is in an arra
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CMS-1345-P 317 disease) or benefici
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CMS-1345-P 319 information. If the
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CMS-1345-P 321 ● Failure to compl
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CMS-1345-P 323 harm to beneficiarie
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CMS-1345-P 325 determinations would
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CMS-1345-P 327 Shared Savings Progr
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CMS-1345-P 329 CMS and OIG have joi
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CMS-1345-P 331 The Antitrust Policy
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CMS-1345-P 333 previously. Such an
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CMS-1345-P 335 protects beneficiary
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CMS-1345-P 337 both Medicare benefi
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CMS-1345-P 339 J. Overlap with Othe
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CMS-1345-P 341 CMS shared savings p
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CMS-1345-P 343 Shared Savings Progr
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CMS-1345-P 345 improve the Shared S
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CMS-1345-P 347 V. Regulatory Impact
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CMS-1345-P 349 The Shared Savings P
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CMS-1345-P 351 ACOs work to improve
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CMS-1345-P 353 presumably provide a
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CMS-1345-P 355 • Number of partic
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CMS-1345-P 357 distribution. With t
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CMS-1345-P 359 c. Further Considera
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CMS-1345-P 361 More specifically, w
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CMS-1345-P 363 program and uncertai
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CMS-1345-P 365 Savings Program at 7
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CMS-1345-P 367 ACO-attributed claim
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CMS-1345-P 369 Category Costs COSTS
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CMS-1345-P 371 For the reasons set
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CMS-1345-P 373 (2) Program requirem
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CMS-1345-P 375 Act. Hospital means
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CMS-1345-P 377 meet the minimum qua
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CMS-1345-P 379 (C) Begin to operate
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CMS-1345-P 381 (D) The civil moneta
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CMS-1345-P 383 prior to the start o
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CMS-1345-P 385 for populations, and
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CMS-1345-P 387 monitoring and evalu
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CMS-1345-P 389 (i) It plans to use
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CMS-1345-P 391 (1) Have a beneficia
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CMS-1345-P 393 who were an ACO part
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CMS-1345-P 395 amount for the patie
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CMS-1345-P 397 under §425.7(b). An
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CMS-1345-P 399 (ii) To be responsib
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CMS-1345-P 401 §425.8 ACO quality
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CMS-1345-P 403 (2) CMS scores indiv
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CMS-1345-P 405 (a) Monitoring of AC
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CMS-1345-P 407 required measure dat
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CMS-1345-P 409 (5) The procedures e
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CMS-1345-P 411 demonstrate in its a
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CMS-1345-P 413 days of the notice o
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CMS-1345-P 415 original notice of d
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CMS-1345-P 417 (c) Notwithstanding
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CMS-1345-P 419 (ii) Quality perform
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CMS-1345-P 421 (i) The beneficiary
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CMS-1345-P 423 terminated from the
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CMS-1345-P 425 inclusion of additio
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CMS-1345-P 427 individuals, better
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CMS-1345-P 04/07/2011] [FR Doc. 201
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(ACO) regulations - American Society of Anesthesiologists

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