Cms Bpci Data Use Agreement

  • September 14, 2021

Prior to the amendment, if a Participant chooses to terminate the BPCI Advanced Agreement for any reason, it would impose a one-year waiting period before that Participant can again “apply” to participate in BPCI Advanced. However, it was unclear whether the one-year wait for the “new application” would prohibit a participant agreeing to apply with a totally different group of downstream episode initiators. However, the amendment now allows downstream episode initiators to recover CMS`s explicit right to collect a reimbursement arrears by reducing payments independent of Medicare. Provided that all contractual downstream episode initiation agreements contain such provisions, CMS has mitigated the secondary source of reimbursement requirements imposed on the participants concerned. Participants in the convener must bear the full financial risk to the CMS on behalf of at least one acute hospital or medical practice and enter into an agreement with a physician group practice or acute hospital requiring the doctor`s office or acute hospital to comply with the terms of the BPCI Advanced model contract. . . .