BENEFICIARY NOTIFICATIONS
It is the policy of the ACO to provide notification to beneficiaries that their provider(s) are participating in a Shared Savings Program, and the opportunity to decline data sharing under 42 CFR §425.312 and 425.708.
Notifications are carried out through the below methods:
Initial Notifications
An ACO or ACO participant must provide each beneficiary with a Beneficiary Information Notification before or at the first primary care visit of the agreement period. ACO participants must post the appropriate signage template in all ACO facilities and make Beneficiary Information Notifications available to beneficiaries upon request in settings where beneficiaries receive primary care services. This notice has to explain that the beneficiary has the option to decline data sharing.
Follow-Up Notifications
Beginning January 1, 2023, in addition to furnishing the Beneficiary Information Notification prior to or at the first primary care visit of the agreement period and posting the signage in all facilities, an ACO must also furnish a follow-up communication at the beneficiary’s next primary care visit OR within 180 -days of the beneficiary receiving the first notification. The follow-up communication affords the ACO the opportunity to have a meaningful dialog with a beneficiary about the benefits of receiving care in an ACO. The follow-up communication offers greater program transparency and empowers beneficiaries to make informed decisions about where they receive their care.
Posters
An ACO or ACO participant must display the CMS Beneficiary Notification Poster in the hospital(s)/clinic(s) where services are rendered to ACO beneficiaries.