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Regulations last checked for updates: Nov 22, 2024
Title 42 - Public Health last revised: Nov 19, 2024
All Titles
Title 42
Chapter IV
Part 512
Subpart E - Subpart E—Transforming Episode Accountability Model (TEAM)
GENERAL
§ 512.500 - Basis and scope of subpart.
§ 512.505 - Definitions.
TEAM PARTICIPATION
§ 512.510 - Voluntary opt-in participation.
§ 512.515 - Geographic areas.
§ 512.520 - Participation tracks.
§ 512.522 - APM options.
SCOPE OF EPISODES BEING TESTED
§ 512.525 - Episodes.
§ 512.535 - Beneficiary inclusion criteria.
§ 512.537 - Determination of the episode.
PRICING METHODOLOGY
§ 512.540 - Determination of preliminary target prices.
§ 512.545 - Determination of reconciliation target prices.
QUALITY MEASURES AND COMPOSITE QUALITY SCORE
§ 512.547 - Quality measures, composite quality score, and display of quality measures.
RECONCILIATION AND REVIEW PROCESS
§ 512.550 - Reconciliation process and determination of the reconciliation payment or repayment amount.
§ 512.552 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.
§ 512.555 - Proration of payments for services that extend beyond an episode.
§ 512.560 - Appeals process.
§ 512.561 - Reconsideration review processes.
DATA SHARING AND OTHER REQUIREMENTS
§ 512.562 - Data sharing with TEAM participants.
§ 512.563 - Health equity reporting.
§ 512.564 - Referral to primary care services.
FINANCIAL ARRANGEMENTS AND BENEFICIARY INCENTIVES
§ 512.565 - Sharing arrangements.
§ 512.568 - Distribution arrangements.
§ 512.570 - Downstream distribution arrangements.
§ 512.575 - TEAM beneficiary incentives.
§ 512.576 - Application of the CMS-sponsored model arrangements and patient incentives safe harbor.
MEDICARE PROGRAM WAIVERS
§ 512.580 - TEAM Medicare Program Waivers
GENERAL PROVISIONS
§ 512.582 - Beneficiary protections.
§ 512.584 - Cooperation in model evaluation and monitoring.
§ 512.586 - Audits and record retention.
§ 512.588 - Rights in data and intellectual property.
§ 512.590 - Monitoring and compliance.
§ 512.592 - Remedial action.
§ 512.594 - Limitations on review.
§ 512.595 - Bankruptcy and other notifications.
§ 512.596 - Termination of TEAM or TEAM participant from model by CMS.
§ 512.598 - Decarbonization and resilience initiative.
authority:
42 U.S.C. 1302
,
1315a
,
and
source:
85 FR 61362, Sept. 29, 2020, unless otherwise noted.
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