Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter H—Health Care Infrastructure and Model Programs |
Part 512 - Standard Provisions for Innovation Center Models and Specific Provisions for Certain Models |
Subpart E - Transforming Episode Accountability Model (TEAM) |
TEAM Participation |
§ 512.510 - Voluntary opt-in participation.
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§ 512.510 Voluntary opt-in participation.
(a) General. Hospitals that wish to voluntarily opt-in to TEAM for the full duration of the model performance period must submit a written participation election letter as described in paragraph (d) of this section during the voluntary participation election period specified in paragraph (c) of this section.
(b) Eligibility. A hospital must not be located in a mandatory CBSA selected for TEAM participation, in accordance with § 512.515, and must satisfy one of the following criteria to be eligible for voluntary opt-in participation election—
(1) Be a participant hospital in the CJR model that participates in CJR until the last day of the last performance year, December 31, 2024; or
(2) Be a hospital participating in the BPCI Advanced model, either as a participant or downstream episode initiator, that participates in BPCI Advanced until the last day of the last performance period, December 31, 2025.
(c) Voluntary participation election period. The voluntary participation election period begins on January 1, 2025 and ends on January 31, 2025.
(d) Voluntary participation election letter. The voluntary participation election letter serves as the model participation agreement. CMS may accept the voluntary participation election letter if the letter meets all of the following criteria:
(1) Includes all of the following:
(i) Hospital name.
(ii) Hospital address.
(iii) Hospital CCN.
(iv) Hospital contact name, telephone number, and email address.
(v) Model name (TEAM).
(2) Includes a certification that the hospital will—
(i) Comply with all applicable requirements of this part and all other laws and regulations applicable to its participation in TEAM; and
(ii) Submit data or information to CMS that is accurate, complete and truthful, including, but not limited to, the participation election letter and any other data or information that CMS uses for purposes of TEAM.
(3) Is signed by the hospital administrator, chief financial officer, or chief executive officer with authority to bind the hospital.
(4) Is submitted in the form and manner specified by CMS.
(e) CMS rejection of participation letter. CMS may reject a participation election letter for reasons including, but not limited to, program integrity concerns or ineligibility, and notifies the hospital of the rejection within 30 days of the determination.