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Notice of Participation in the CMS ACCESS Model

The services offered by Florida Elder Care are provided as part of a new federal payment model test being conducted by the Centers for Medicare & Medicaid Services (CMS), known as the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. This page describes the notices and consent terms that apply when you check your eligibility for and align with ACCESS services through Florida Elder Care.

Notice Regarding Participation in a CMS Payment Model

The services offered by Florida Elder Care are provided as part of a new federal payment model test being conducted by the Centers for Medicare & Medicaid Services (CMS), known as the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. By proceeding, you acknowledge that you have been informed of the following:

  • Data Sharing. In connection with ACCESS, Florida Elder Care may share your health information with CMS. CMS may also access or request your health information — including through Health Information Exchanges (HIEs) or other sources — in connection with the program’s evaluation. Any such sharing is subject to applicable federal privacy and security protections.
  • Control Group Assignment. You may be randomly assigned to a control group and be ineligible to enroll in ACCESS with any participating health care provider for 12 months, unless otherwise stated by CMS. Assignment to the control group will not otherwise affect your Medicare benefits, rights, or coverage.

Consent to Receive ACCESS Services

The services offered by Florida Elder Care are provided as part of a new federal payment model test being conducted by the Centers for Medicare & Medicaid Services (CMS), known as the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. By enrolling, or aligning, with Florida Elder Care to receive ACCESS services, you acknowledge the following:

  1. Voluntary Alignment. Your alignment with Florida Elder Care in the ACCESS model is entirely voluntary. You are not required to align, and your Medicare benefits will not be affected by your decision to align or not align.
  2. Cost-Sharing. There is no cost-sharing for these services. Your cost-sharing amount associated with these services is $0 per month for the duration of your alignment with Florida Elder Care.
  3. Right to Disenroll (Unalign). You may end your alignment with Florida Elder Care — and, if you choose, align with another participating health care provider — at any time beginning 90 days after your initial alignment date.
  4. One Provider Per Clinical Track. You may only be aligned with one participating health care provider per ACCESS clinical track at any given time. However, you may be aligned in multiple different clinical tracks simultaneously — with the same or different health care providers — for each clinical track in which you have a qualifying condition. See the ACCESS Model Webpage for a list of clinical tracks and associated policies.
  5. Claims Data Sharing. Your Medicare claims data may be shared with Florida Elder Care, subject to all applicable privacy and security protections, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

If You Are Assigned to the Comparison Group

You are not eligible to enroll.

These services are part of a federal payment model test being conducted by the Centers for Medicare & Medicaid Services (CMS). To evaluate the model, some individuals are assigned to a comparison group and are not eligible to enroll for 12 months. This is a random assignment made by CMS for evaluation purposes only and is not based on anything about you or your health. You may continue to receive other services as usual and your Medicare coverage, benefits, and rights are not affected in any way. If you have questions, you may call 1-800-MEDICARE (1-800-633-4227). Teletypewriter (TTY) users call 1-877-486-2048.