(2) A care management plan for beneficiaries admitted to an NWS subsidiary. In addition to meeting the specific qualification criteria, ACOs must submit a list of NSW members and present SNF partnership agreements as an example to apply for the waiver. In addition, they must enter into an NWS membership agreement for each proposed partner – complete a table of contracts in the ACO management system – and submit plans for communication, assessment and accreditation of beneficiaries and management of care. 1. Waiver declarations will come into effect with CMS authorization for the waiver or the start date of the participation agreement, depending on what is later. (1) The communication plan between the ACO and its SNF subsidiaries. In support of ACOs` efforts to improve quality and cost reduction, CMS has entered into a waiver of the 3-day rule for eligible SMAs participating in certain performance-based risk initiatives of the shared saving program (No. 425.612). Eligible ACOs can apply for the use of a 3-day NWS waiver for the duration of their contract or at the time of enrollment in the program.
ACOs, including those applying for a waiver for the duration of an existing participation agreement, must follow the annual application process. For PY 2019, the waiver of the 3-day NWS rule will be effective from July 1 after the approval of an SNF 3-Day rule. (C) it is considered that an NSF intends to provide services in accordance with the 3-day NFS exemption in paragraph (a) (1) of this section, where the SNF presenting the claim is an NSF member of an ACO for which such a waiver has been authorized. (D) CMS does not make payments for SNF services to an ACO NSS subsidiary; for which a waiver of the 3-day NFS rule was authorized where the NWS member authorizes a non-prospective FFS recipient or, as a general rule, has been prospectively assigned to the ACO prior to the approval of the NFS, but subsequently excluded, and the additional 90-day period referred to in paragraph (1) iv) of this section has expired. As part of the shared savings program, the Centers for Medicare – Medicaid Services (CMS) enter into a participation agreement with each participating responsible care organization (ACO). CMS rewards legitimate ACSs if they reduce the cost growth of Medicare Parts A and B fee-for-service (FFS) (compared to their specific ACO repository) at the same time as they meet performance standards for quality of care. (A) 1. The beneficiary was forward-lookingly assigned at the beginning of the current benefit year to a OCO that has a forward-looking assignment after . 425,400 (a) (3), but in the latest quarterly update of the list of disposals in accordance with . 425.401 (b) and the recipient was admitted to an NWS member within 90 days of the date the CMS forwarded the quarterly exclusion list to the ACO; or (B) a list of SNF with which the ACO collaborates, as well as written partnership contracts with the SNF between the ACO and each publicly traded SNF. iv) For a beneficiary on the prospective list or provisional allocation of the ACO prospectus at the beginning of the benefit year or on the first, second or third provisional list of prospecting for the year of benefit, for which a waiver of the three-day NSF rule referred to in paragraph a) (1) was subsequently removed from the assignment list for the benefit year , the CMS makes payments for the SNF benefits provided to the recipient by an NWS member, if the following conditions are met: iii) NFS eligible for this waiver and concluding written agreements with ACO must: (1) SNF rule 3 days.