ACO Participation Waiver

AWV Scheduling Initiative:

• Parties to the arrangement: Equality Health ACO and ACO Participants
• Date of arrangement: January 1, 2025
• Items, services, goods, or facility provided: See description below
• Date and nature of any amendments to the arrangement, if applicable: N/A

The board made a bona fide determination effective January 1, 2025, that the AWV Scheduling Initiative is reasonably related to the purpose of the MSSP to manage and coordinate care for Medicare fee-for-service beneficiaries throughout the ACO.  The AWV Scheduling initiative is intended to increase the likelihood that patients whom CMS has identified as assigned or assignable to the ACO under the MMSP and whom CMS has recognized would benefit from an AWV will receive an AWV. The AWV Scheduling initiative includes a provision of scheduling services to ACO participants at no cost to assist in increasing availability and performance of medically necessary and appropriate AWVs on patients whom CMS has identified as assigned to the ACO under the MSSP. Equality Health in collaboration with, and subject to the approval of, ACO shall develop and implement appropriate operating processes and procedures to implement the AWV Scheduling Initiative and ensure that the provision of services on a no cost basis is limited to the AWV Scheduling Initiative, unless otherwise approved by the Board of Managers. ACO participants shall ensure that each completed AWV shall include all required elements and associated quality data for patients whom CMS has identified as assigned to the ACO under the MSSP.