Beneficiary Notifications Sample Clauses
The Beneficiary Notifications clause requires that beneficiaries are promptly informed about relevant events, actions, or changes that may affect their rights or interests under an agreement. Typically, this clause outlines the methods and timing for delivering notifications, such as via email or registered mail, and may specify what types of information must be communicated, like changes in policy, payment status, or eligibility. Its core function is to ensure transparency and timely communication, thereby protecting beneficiaries from being unaware of important developments that could impact their benefits or obligations.
Beneficiary Notifications. A. In a form and manner and by one or more dates specified by CMS, the ACO shall provide written notice to all Beneficiaries who have been aligned to the ACO for a Performance Year.
B. For purposes of the Beneficiary notification required under Section 5.05.A, the ACO shall use a template letter provided by CMS, in which CMS will designate letter content that the ACO shall not change, as well as places in which the ACO may insert its own original content.
C. In accordance with Section 5.04.J, the ACO shall submit the final Beneficiary notification letter, including any original content inserted by the ACO, for CMS approval prior to sending such letter to Beneficiaries. The final Beneficiary notification letter will be deemed approved as described in Section 5.04.J.2, unless CMS provides a written notice of disapproval.
D. CMS may issue written notice of disapproval of the final Beneficiary notification letter at any time, including after the Beneficiary notification letter is deemed approved as described in Section 5.04.J.2.
Beneficiary Notifications. A. In a form and manner and by one or more dates specified by CMS, the ACO shall provide written notice to all Beneficiaries who have been aligned to the ACO beginning January 1 of the Performance Year and, starting in Performance Year 2025, remain aligned as of April 30 of the Performance Year.
B. For purposes of the Beneficiary notification required under Section 5.05.A, the ACO shall use a template letter provided by CMS, in which CMS will designate letter content that the ACO shall not change, as well as places in which the ACO may insert its own original content.
C. In accordance with Section 5.04.J, the ACO shall submit the final Beneficiary notification letter, including any original content inserted by the ACO, for CMS approval prior to sending such letter to Beneficiaries. The final Beneficiary notification letter will be deemed approved as described in Section 5.04.J.2, unless CMS provides a written notice of disapproval.
D. CMS may issue written notice of disapproval of the final Beneficiary notification letter at any time, including after the Beneficiary notification letter is deemed approved as described in Section 5.04.J.2.
E. Notwithstanding Section 5.05.A, in a form and manner and by one or more dates specified by CMS, the ACO shall provide written notice to all Beneficiaries who have been aligned to the ACO after April 30 of the Performance Year.
Beneficiary Notifications. 1. Within 30 days after CMS has provided the ACO with its Next Generation Beneficiary alignment list for a Performance Year, the ACO shall provide Next Generation Beneficiaries notice in writing that they have been aligned to the ACO for the Performance Year.
2. CMS shall provide the ACO with a template letter indicating letter content that the ACO shall not change and places in which the ACO may insert its own original content.
Beneficiary Notifications.
1. In a form and manner and by a date specified by CMS, the ACO shall provide Next Generation Beneficiaries notice in writing that they have been aligned to the ACO for the Performance Year.
2. CMS shall provide the ACO with a template letter indicating letter content that the ACO shall not change and places in which the ACO may insert its own original content.
Beneficiary Notifications. (a) Parties must develop, maintain, and implement written processes to obtain and document ET3 Model Beneficiary consent and/or refusal of an offer by the ET3 Partner or Downstream Practitioner to furnish Covered Services related to an ET3 Model Intervention during an Encounter, consistent with all applicable federal, state, and local laws and requirements. Documentation of such processes, both current and historical, must be maintained in accordance with Article 18.2.
(b) Information and education provided to beneficiaries for purposes of obtaining their consent or refusal for Covered Services in compliance with this Article 11.1 is not considered promotion, marketing, or advertising for the purposes of Article 11.4.
(c) Parties must ensure that ET3 Model Beneficiaries are entitled to the same notifications as all other Medicare beneficiaries, including Advance Beneficiary Notices, if applicable. The ET3 Partner may reference the Medicare Claims Processing Manual, Chapter 30, Sections 40.3, 40.4, 50.15.2 for guidance on applicable policies on Emergencies or Urgent Situations.
(d) Parties must ensure that any notice furnished to an ET3 Model Beneficiary for purposes of complying with this Article 11.1 is provided in such a way that it addresses the needs of the ET3 Model Beneficiary and their families and/or caregivers with limited English proficiency or low or limited health literacy.