May 11, 2021

Volume XI, Number 131

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May 11, 2021

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May 10, 2021

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CMS Announces Final Organizations for the Global and Professional Direct Contracting Model, Halts Additional Applications and Future Solicitations

On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”) Model (previously named the Direct Contracting Model for Global and Professional Options).  The 53 Direct Contracting Entities (“DCEs”) are participating in the first Performance year (“PY2021”) of the GPDC Model, which runs from April 1, 2021 through December 31, 2021. The DCEs will serve Medicare fee-for-service (“FFS”) beneficiaries in 38 states as well as in the District of Columbia and Puerto Rico.

The Innovation Center announced it will not be accepting new applications for any of the GPDC Model participant types, including for Medicaid Managed Care Organization-based DCEs.  The Innovation Center also announced it will not solicit applications for a second round of participants to start the GPDC Model on January 1, 2022.  However, organizations that applied in the previous application cycles—either for the Implementation Period or for PY2021—and that deferred their start date to January 1, 2022 will be permitted to start the GPDC Model as planned on January 1, 2022, as long as they continue to meet GPDC Model requirements.

The GDPC Model is a set of two voluntary risk-sharing options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare FFS, also known as Original Medicare.  The GDPC Model aims to build upon lessons learned from prior innovation models and private sector risk-sharing arrangements and to test the next evolution of risk-sharing arrangements to produce value and high-quality health care.  The risk-sharing options are expected to reduce burden, support a focus on beneficiaries with complex, chronic conditions, and encourage participation from organizations that have not typically participated in Medicare FFS or Innovation Center Models.

The Innovation Center updated its FAQs on the GPDC Model web page to reflect the above changes.  The Innovation Center encourages you to monitor the GPDC Model web page for future updates and to contact their help desk with any questions or comments at DPC@cms.hhs.gov.

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Copyright © 2021, Sheppard Mullin Richter & Hampton LLP.National Law Review, Volume XI, Number 99
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About this Author

Lynsey Mitchel Corporate Attorney Sheppard Mullin Century City, CA
Partner

Lynsey Mitchel is a partner in the Corporate Practice Group in the firm's Century City office, a leader of the Health Plan Practice and a member of the firm's Healthcare team.

Areas of Practice

Lynsey represents health maintenance organizations, managed care organizations, medical groups, hospitals, home health providers, medical device retailers and other healthcare entities and providers.

Lynsey has deep expertise in managed care, including HMO regulatory matters and has assisted numerous clients to obtain HMO licensure as healthcare service plans under California’...

310-228-3745
Matthew Goldman, Corporate Attorney, Sheppard Mullin Law Firm
Associate

Matthew Goldman is an associate in the Corporate Practice Group in the firm's Century City office and is a member of the firm's healthcare practice team.

Areas of Practice

Matthew’s practice blends the regulatory and transactional components of healthcare law, and includes representation of hospitals, managed care organizations, medical groups, and other healthcare entities and providers. On the regulatory side, Matthew’s practice is focused on licensing, regulatory compliance, and managed care arrangements. Matthew has extensive experience preparing Knox-...

310.228.2285
Ariana Stobaugh Corporate Attorney Sheppard Mullin Law Firm Century City
Associate

Ariana Stobaugh is an associate in the Corporate Practice Group in the firm's Century City office and is a member of the firm’s Healthcare team.

Areas of Practice

Ariana advises healthcare organizations on business, regulatory and transactional matters.

Prior to joining Sheppard Mullin, she worked as a high school English teacher in Los Angeles.  While attending law school at USC Gould School of Law, she served as an extern at Public Counsel and Neighborhood Legal Services....

424-288-5301
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