№ files_lp_4_process_1_31531
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Character count: 41988
File size: 94 KB
Administrative form outlining requirements and procedures for payer-initiated submissions to CMS for determining eligibility of payment arrangements as Other Payer Advanced Alternative Payment Models under federal regulation
Program:
Quality Payment Program
Organizing Body:
Centers for Medicare & Medicaid Services (CMS)
Country:
United States
Legal Basis:
42 CFR § 414.1420
Document Type:
Administrative submission form
Form Type:
Payer Initiated Submission Form
Purpose:
Determination of Other Payer Advanced Alternative Payment Models (APMs)
Applicable Payers:
State Medicaid Agencies, Medicare Health Plans, Commercial or Private Payers
Submission Method:
Electronic submission
Sections:
Payer Identifying Information; Payment Arrangement Information; Supporting Documentation; Certification Statement
Relevant Programs:
Medicaid (Title XIX), Medicare Advantage, Commercial Health Plans
Submission Deadlines:
April 1 (Medicaid); Medicare Advantage bid deadline (Medicare); June 1 (Commercial/Private)
Review Process:
CMS evaluation with possible request for additional information within 15 business days
Outcome:
Determination of APM status, final and not subject to reconsideration
Related System:
Health Plan Management System (HPMS)
Supporting Materials:
Contracts, agreements, and related documentation
Performance Period Reference:
Year prior to QP Performance Period
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2017
Region / City:
United Kingdom
Theme:
Money laundering, risk assessment
Document Type:
Template
Organization:
Not specified
Author:
Not specified
Target Audience:
Firms subject to MLR 2017
Period of validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Context:
A template for conducting a risk assessment in compliance with MLR 2017, detailing risk factors related to clients, geography, services, transactions, and delivery channels.
Year:
2017
Region / city:
United Kingdom
Subject:
Anti-money laundering, terrorist financing
Document type:
Application form
Organization / institution:
Financial Conduct Authority
Author:
Financial Conduct Authority
Target audience:
Financial institutions, legal entities, applicants for authorization
Effective period:
N/A
Approval date:
N/A
Date of amendments:
N/A
Contextual description:
Legal and regulatory document providing an application form for individual MLR (Money Laundering Regulations) approval in accordance with UK financial regulations.
Year:
2017
Region / City:
United Kingdom
Topic:
Money Laundering, Terrorist Financing, Financial Regulation
Document Type:
Regulatory Guidance
Organization:
Financial Conduct Authority (FCA)
Author:
Financial Conduct Authority (FCA)
Target Audience:
Financial institutions, applicants for registration as an Annex I Financial Institution, MLR Individuals
Period of validity:
Not specified
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2021
Region / city:
United States
Topic:
Male stress urinary incontinence treatment
Document type:
Clinical guideline
Institution:
HERC (Health Economics Research Center)
Author:
HERC staff
Target audience:
Healthcare providers
Action period:
Not specified
Approval date:
November 2021
Revision date:
Not specified
Year:
2010
Region / city:
United Kingdom
Topic:
Taxation, Hybrid Entities
Document Type:
Taxation Analysis
Authority:
Tax Law
Author:
Unknown
Target Audience:
Tax professionals, legal experts, corporate entities
Effective Period:
Indefinite
Date of Approval:
Unknown
Date of Modifications:
Unknown
Organization:
Navigator
Facility:
Windemere
Location:
Martha’s Vineyard
State:
Massachusetts
Type of Document:
Applicant response submission
Regulatory Context:
DoN review process
Regulatory Authority:
Massachusetts Department of Public Health
Related Regulation:
105 CMR 150.000: Standards for Long-Term Care Facilities
Time Period Covered:
FY17–FY22; Projections for 2026
Submission Deadline:
December 21, 2022
Patient Population:
Long-term care residents
Total Beds (Historical):
61 beds
Total Rooms:
32 rooms
Room Configuration:
24 double rooms sharing bathrooms (48 beds); 5 double rooms with private bathrooms (10 beds); 3 single rooms with private bathrooms (3 beds)
Total Individual Patients (Most Recent 36 Months):
60
Waitlist:
15 Island residents
Confirmed Off-Island Residents:
Minimum of 13
Staff Housing Plan:
30 one-bedroom affordable units
Housing Partner:
MVH
Other Licensed Facility on Island:
Henrietta Brewer House (14-bed assisted living residence)
Projected Total Beds (2026):
70
Year:
2026
Document Type:
Submission Form
Program:
Quality Payment Program (QPP)
Intended Users:
State Medicaid Agencies, Medicare Health Plans, Commercial or Private Payers
Regulation Reference:
42 CFR § 414.1420
Submission Deadline:
Varies by payer type (April 1 for Medicaid, Medicare Advantage bid deadline for Medicare, June 1 for commercial/private)
Sections Included:
Payer Identifying Information, Payment Arrangement Information, Supporting Documentation, Certification Statement
Format:
Electronic submission
Purpose:
Request determination of Other Payer Advanced Alternative Payment Model status
Notification:
CMS posts determinations on CMS website and notifies submitters
Supporting Materials:
Contracts or alternative documentation validating payment arrangements
Year:
2026
Region / State:
United States
Subject:
Healthcare Payment Arrangements
Document Type:
Submission Form
Organization / Agency:
Centers for Medicare & Medicaid Services (CMS)
Author:
CMS
Target Audience:
State Medicaid Agencies, Medicare Health Plans, Commercial or Private Payers
Deadline:
Varies by payer type
Sections:
Payer Identifying Information, Payment Arrangement Information, Supporting Documentation, Certification Statement
Submission Method:
Electronic
Regulatory Reference:
42 CFR § 414.1420
Document code:
INTM553250
Country:
United Kingdom
Legislation:
Taxation (International and Other Provisions) Act 2010 (TIOPA 2010)
Relevant sections:
s259EA, s259BE, s259EC, s259NA
Issuing body:
HM Revenue and Customs
Document type:
Tax guidance example
Topic:
Hybrid mismatch rules
Subject:
Hybrid payer deduction/non-inclusion mismatch
Chapter:
Chapter 5 – Hybrid payer
Entities described:
Co.1, Co.2, Co.3
Jurisdictions referenced:
Country X, Country Y
Corporate structure:
Parent company, hybrid subsidiary, operating subsidiary
Financial arrangement:
Intercompany loans and interest payments
Key concept:
Dual inclusion income
Analytical focus:
Conditions A–E test for hybrid payer mismatch and counteraction mechanisms
Year:
2026
Region / Country:
United States
Topic:
Health Care Reform
Document Type:
Informational Analysis
Organization / Institution:
Independent Research or Advocacy Group
Author:
Not specified
Target Audience:
General public interested in health policy
Related Legislation:
Affordable Care Act (ACA), HR 676
Key Issues Addressed:
Single payer misconceptions, health insurance coverage, quality of care, physician perspectives
Comparative Data:
US health system rankings by WHO and other international comparisons
Timeframe Discussed:
2011–2020
Year:
2023
Region / City:
Texas
Topic:
Environmental Compliance
Document Type:
Public Hearing Requirement Form
Organization / Institution:
Texas Department of Transportation (TxDOT)
Author:
Texas Department of Transportation (TxDOT)
Target Audience:
Project managers, environmental review staff, and regulatory bodies
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Note:
Contextual Description
Year:
2024
Region / City:
Indiana
Topic:
Historic Preservation, Section 106 Process
Document Type:
Template
Agency:
Federal Highway Administration, Indiana Department of Transportation
Author:
Federal Highway Administration
Target Audience:
Consultants, State Historic Preservation Officer, Federal and State Agencies
Validity Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
Not specified
Jurisdiction:
United States
Subject:
Veterans’ benefits apportionment
Document type:
Training handout
Issuing authority:
Department of Veterans Affairs
Legal basis:
38 U.S.C. §§ 1505, 5307, 5502(d), 5503, 6103(e), 6104(c)
Regulatory references:
38 CFR §§ 3.450–3.461
Administrative references:
M21-1, Part III, Subparts ii and v
Intended audience:
Trainees
Applies to benefits:
Pension, compensation, dependency and indemnity compensation
Source type:
Administrative guidance and legal reference material
Jurisdiction:
United States
Education programs:
Part C Early Intervention; Part B Early Childhood Special Education
Governing framework:
Individuals with Disabilities Education Act
Target population:
Children with potential eligibility for special education services aged 2 to 3
Key actors:
Parents; Local Education Agency; State Education Agency; Part C providers
Transition age criteria:
Third birthday; September 30 cutoff
Referral timeline:
At least 90 days before anticipated transition; April 1 for school year entry
Eligibility determination timeline:
65 business days
IEP timeline:
Within 30 calendar days after eligibility determination
Meeting types:
Transition conference; eligibility meeting; IEP meeting
Document type:
Policy comparison and procedural guidance
Year:
2014
State:
Alabama
Area:
Alabama Counties of Calhoun, Cherokee, Clay, Cleburne, De Kalb, Etowah, Talladega
Wage Determination No.:
2005-2001
Revision No.:
12
Date Of Revision:
06/19/2013
States:
Alabama, Georgia
Note:
Area
Alabama Counties of Barbour, Coffee, Dale, Geneva, Henry, Houston
Note:
Year
Subject:
Environmental Assessment
Document Type:
Environmental Review
Organization / Institution:
HUD
Target Audience:
Responsible Entities, Project Managers, Environmental Assessors
Program:
Housing Choice Voucher (HCV) Program
Governing Regulations:
24 CFR 982 Subpart I; 24 CFR 982.507; 24 CFR 982.401; 24 CFR 100.203; 28 CFR 35.151(c)
Federal Authority:
U.S. Department of Housing and Urban Development (HUD)
Local Authority:
Public Housing Agency (PHA); OHCD
Effective Date of Biennial Inspection Policy:
July 1, 2014
Subject Matter:
Housing Quality Standards (HQS); Rent Reasonableness; Unit Inspections; Accessibility Modifications
Document Type:
Administrative policy chapter
Applicable Housing Types:
HCV-assisted units; special housing types; homeownership units (as applicable)
Referenced Guidance:
Housing Choice Voucher Guidebook Chapter 10; HUD Housing Inspection Manual for Section 8 Housing; HUD Forms 52580 and 52580-A; HUD Notice 2003-31
Standards Covered:
Sanitary facilities; food preparation and refuse disposal; space and security; thermal environment; illumination and electricity; structure and materials; interior air quality; water supply; lead-based paint; access; site and neighborhood; sanitary condition; smoke detectors
Document type:
Technical guidelines and sample determinations
Subject:
Water quality assessment and soil stabilization practices
Geographic references:
Madawaska Lake, Aroostook County; Tomah Lake, Washington County; Maine
Institutions referenced:
Maine Department of Environmental Protection
Key topics:
Phosphorus loading; Shoreline development density; Run-off coefficient; Drainage area; Vegetative stabilization; Fertilizer application
Measurement units:
Grams per year; Parts per billion; Square feet; Meters squared; Feet of shoreline
Seasonal period referenced:
May 1 to September 15
Regulatory context:
Shoreland development and soil disturbance during construction projects
Year:
2014
Region / City:
Oklahoma
Subject:
Wage Determination
Document Type:
Official Register
Authority / Institution:
U.S. Department of Labor
Author:
Diane C. Koplewski
Target Audience:
Contractors, Employers
Period of Validity:
From 01/01/2015
Approval Date:
12/30/2014
Revision Date:
12/22/2014