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e-CFR data is current as of February 23, 2021

Title 42Chapter IVSubchapter HPart 512


TITLE 42—Public Health

CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)

SUBCHAPTER H—HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS

PART 512—RADIATION ONCOLOGY MODEL AND END STAGE RENAL DISEASE TREATMENT CHOICES MODEL

rule

Subpart A—GENERAL PROVISIONS RELATED TO INNOVATION CENTER MODELS

§512.100
Basis and scope.
§512.110
Definitions.
§512.120
Beneficiary protections.
§512.130
Cooperation in model evaluation and monitoring.
§512.135
Audits and record retention.
§512.140
Rights in data and intellectual property.
§512.150
Monitoring and compliance.
§512.160
Remedial action.
§512.165
Innovation center model termination by CMS.
§512.170
Limitations on review.
§512.180
Miscellaneous provisions on bankruptcy and other notifications.
rule

Subpart B—RADIATION ONCOLOGY MODEL

General

§512.200
Basis and scope of subpart.
§512.205
Definitions.

RO Model Participation

§512.210
RO participants and geographic areas.
§512.215
Beneficiary population.
§512.217
Identification of individual practitioners.
§512.220
RO participant compliance with RO Model requirements.
§512.225
Beneficiary notification.

Scope of RO Episodes Being Tested

§512.230
Criteria for determining cancer types.
§512.235
Included RT services.
§512.240
Included modalities.
§512.245
Included RO episodes.

Pricing Methodology

§512.250
Determination of national base rates.
§512.255
Determination of participant-specific professional episode payment and participant-specific technical episode payment amounts.

Billing and Payment

§512.260
Billing.
§512.265
Payment.
§512.270
Treatment of add-on payments under existing Medicare payment systems.

Data Reporting

§512.275
Quality measures, clinical data, and reporting.

Medicare Program Waivers

§512.280
RO Model Medicare program waivers.

Reconciliation and Review Process

§512.285
Reconciliation process.
§512.290
Timely error notice and reconsideration review process.
rule

Subpart C—ESRD TREATMENT CHOICES MODEL

General

§512.300
Basis and scope.
§512.310
Definitions.

ESRD Treatment Choices Model Scope and Participants

§512.320
Duration.
§512.325
Participant selection and geographic areas.
§512.330
Beneficiary notification.

Home Dialysis Payment Adjustment

§512.340
Payments subject to the Facility HDPA.
§512.345
Payments subject to the Clinician HDPA.
§512.350
Schedule of home dialysis payment adjustments.

Performance Payment Adjustment

§512.355
Schedule of performance assessment and performance payment adjustment.
§512.360
Beneficiary population and attribution.
§512.365
Performance assessment.
§512.370
Benchmarking and scoring.
§512.375
Payments subject to adjustment.
§512.380
PPA Amounts and schedules.
§512.385
PPA exclusions.
§512.390
Notification and targeted review.

Quality Monitoring

§512.395
Quality measures.

Medicare Program Waivers

§512.397
ETC Model Medicare program waivers.

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