We propose that under new 425.640(f), CMS would notify in writing each ACO of its determination of the amount of prepaid shared savings
Accordingly, for these reasons and because sections 1861(s)(2), 1861(jjj)(1)(A), and 1833(a)(1) of the Act provide that the Secretary is to provide coverage and payment for OUD treatment services including opioid agonist and antagonist medications that are FDA approved for use in the treatment of OUD, we are proposing to establish payment for the weekly and monthly formulations for this new FDA-approved injectable buprenorphine product, Brixadi, which we believe would further efforts to address the opioid crisis and expand access to evidence-based treatment for OUD
We are also concerned about balancing adjustments for billing activity that rises to the level of SAHS versus removing payment amounts associated with billing activity due to inefficiencies that are within the ACO's control
RHCs and FQHCs are paid for the non-face-to-face care management work involved in coordinating care
[2] The level of risk varies between different types of products and producing regions
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