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The adjusted updated benchmark values (row [C]) and adjusted PY expenditures for ACO assigned beneficiaries by enrollment type (row [D]), also described in Table 41, are multiplied by original PY assigned beneficiary proportions by enrollment type (row [E]), and summed across enrollment types to recalculate the per capita updated benchmark (row [F]) and per capita ACO PY assigned beneficiary expenditures (row [G])

Mejia AB, Ling PM

Lastly, we propose a process for ACOs to request that CMS reopen a payment determination (as described in section III.G.7.c.(2).(e) of this proposed rule), and briefly discuss the role of ACOs in preventing and reporting Medicare fraud (as described in section III.G.7.c.(2).(f) of this proposed rule)

For MIPS CQM and QCDR collection types, we estimate an additional time for respondents (individual clinicians and groups) to become familiar with MIPS quality measure specifications and, in some cases, specialty measure sets and QCDR measures

The remaining 20 percent is the beneficiary copayment