Eligibility Checklist

Use this checklist to determine if your organization qualifies to participate in the ACCESS Model.

Organization Requirements

Medicare Part B Enrollment — Organization must be enrolled in Medicare Part B as a provider or supplier

Exclusions Check — Organization is NOT a Durable Medical Equipment (DME), Prosthetics, Orthotics, and Supplies supplier or laboratory supplier

Active TIN — Organization has an active Taxpayer Identification Number

Clinical Director — Designated a Medicare-enrolled physician to serve as Clinical Director

Clinical Oversight — Clinical Director will oversee care quality and compliance

Compliance Responsibility — Clinical Director accepts responsibility for regulatory compliance

State Licensure — Organization complies with all applicable state licensure requirements

HIPAA Compliance — Organization is a HIPAA-covered entity with privacy and security policies in place

FDA Compliance — If using digital health tools/devices, organization meets FDA requirements or operates under FDA enforcement discretion

API Readiness — Organization can report required measures via CMS-hosted APIs

HIE Integration — Organization can integrate with a Health Information Exchange or similar trusted network

Electronic Updates — Organization can send electronic care plans and updates to referring clinicians

Track Identified — Organization has identified which clinical track(s) to participate in

Condition Management — Organization can manage ALL qualifying conditions within selected track(s)

Outcome Measurement — Organization can measure and report required outcomes for selected track(s)