In this next section, we'll review scoring, timeline, and resources. We'll start by explaining the scoring threshold requirements for CY 2027 From there, we'll walk through the timeline and key dates for this UI 2027 SNP Model of Care Cure process, so you know what is due and when And finally, we'll point you to the resources available to support you along the way. By the end of this section, you should know what to expect for the Cure process, along with the required next steps and the resources available to you. Next slide. We'd now like to review the SNP model of care scoring requirements. Please note that plans are required to meet two minimum scoring thresholds to obtain approval from model of care implementation. First, SNPs must earn a minimum score of 50% for each element, regardless of the overall score And second, SNPs must earn an overall score of at least 70% If a plan does not meet either of these thresholds during the initial review period, the plan will receive a notice of intent to deny or NOID letter. In this instance, your organization will need to submit a revised Model of Care Narrative during what we refer to as the Cure Period The Cure Period is a one-time opportunity for SNPs to address the identified deficiencies and meet the minimum scoring thresholds Plans required to cure their documentation will receive only a one-year approval period regardless of their final score. At this time, we'd also like to take an opportunity to briefly differentiate between the model of care review and the CMS SNP audit. in the MA regulations for SNPs, regardless of what's been included or described in the approved model of care. Next slide, please. So this slide provides an overview of the contract year 2027 SNP Model of Care Approval timeline As a reminder, beginning this year, the model of care submission deadline now aligns with the Medicare Advantage statutory bid submission deadline and state Medicaid agency contracting processes. This year, the Model of Care submission deadline was May 29th and final bids were due to CMS on Monday, June 1st. Following review of the SNP models of care, approval and denial notices were circulated via HPMS as of August 3 Plans that received Notice of Intent to deny or NOID letters are required to address deficiencies during the designated Cure Period All CARE submissions must be uploaded to HPMS by 8 PM Eastern Time on August 13th Following this deadline, the Cure documentation will be reviewed and CMS will issue approval and denial notices related to the cure period on September 1st. Next slide. Before we move on, I want to emphasize two important upcoming key dates mentioned on the previous slide to be mindful of for the CY 2027 Model of Care Cure Cure process The first is Thursday, August 13th at 8pm Eastern Time. This is the deadline for plans to upload the revised model of care and matrix documentation to HPMS. I do want to emphasize that this is a firm deadline. Late submissions are not accepted, so please plan to complete your upload ahead of the deadline The second is Tuesday, September 1st, when CMS will issue the Cure approval and denial notices. This activity will conclude the CY 2027 model of care review cycle. Please be sure to note these dates and plan your submission timeline accordingly. Next slide, please I also want to point everyone to NCQA SNP approval website located at SNPMOC.ncqa.org. All of the CY 2027 SNP Model of Care resources are posted here, including the Model of Care Matrix for CY 2027 The CY 2027 scoring guidelines Frequently asked questions and the CUI 2027 plan trainings and technical assistance call slides and recordings. We'd like to emphasize the importance of reviewing these resources as you prepare your Cure documentation. In particular, the scoring guidelines provide detailed information on the scoring requirements Using them as you revise your model of care narrative is the best way to make sure your care submission fully addresses the identified deficiencies and meets the CY 2027 scoring requirements. Please note that the links to the NCQA SNP approval website, as well as the other resources listed on the slide will be shared via chat with all attendees momentarily. Next slide, please. This slide includes information related to technical assistance As mentioned on the previous slide, you can access a variety of SNP model of care resources on the NCQA SNP approval website. For inquiries related to model of care requirements or regulation questions, please contact CMS at the address included in the middle column of the slide and enter SNP Model of Care Inquiry in the subject line. Please submit a SNP application inquiries via the CMS SNP mailbox. Type the address included in the right column of this slide, and then select the SNP mailbox. Once you do this, enter SNP application inquiry in the subject line. And that concludes this portion of today's session on scoring timeline, and resources. Next slide, please. We're now going to turn to guidance on the Cure submission process for CY 2027. Over the next several slides we'll walk through who is required to submit Cure documentation, where and when submissions are due, and the specific requirements your revised documentation needs to meet. These slides are meant to make the expectations as clear as possible, so you can put together a complete on-time submission that satisfies all requirements. Next slide. So let's start with who must cure. Again, a cure is required for all plans that received a notice of intent to deny, or NOID. That is, any plan scoring below 50% on one or more individual element or below 70% overall. If your organization received annoyed, you are required to submit revised documentation for the element or elements that were identified as deficient in your NOIT letter Next, where to submit. All revised documentation is uploaded through HPMS. Please upload only the model of care and the associated matrix. Do not include any other documentation, as NCQA only downloads and reviews the model of care and matrix. And finally, when Cure documentation is due. Again, to emphasize, submissions must be uploaded by 8 PM Eastern Time on Thursday, August 13th. Please plan ahead to ensure that you submit your Cure documentation prior to the deadline as late submissions are not accepted. Next slide. This slide covers what your Cure submission needs to include. First, revise only the factors that were identified in your NOID as deficient. If a factor was not flagged as deficient, do not make any changes to it. We are only looking for revisions to the items scored as not met. Second, resubmit both the model of care narrative and the matrix. I want to take a moment to emphasize this point, because we know it has been a source of confusion for plans in the past. Please upload only these two documents to HPMS, the model of care narrative and the matrix And do not upload any other documents. NCQA only downloads and reviews these two documents. As a result, any information required for evaluation must be included as part of the model of care narrative itself For example, as an appendix within the document, rather than submit it as a separate file Finally, be sure to identify every change from your original submission so that reviewers can clearly see and understand the revisions made to your documentation. We will discuss how to do this in terms of formatting on the following slides. Next slide, please. This slide walks through how to revise your documentation. We'll review it in three parts. What to revise, how to show your edits, and where to find guidance. In terms of which factors to revise, again, please revise the factors scored as not met in any element that scored below 50%, along with any individual factor scored as not met. As you work through each one, be sure to address all of its requirements. Many factors have multiple components, and every component needs to be addressed for the factor to be scored as met. I want to underscore an important reminder that has come up previously. Only revise the factors that were cited as deficient. If a factor was scored as met, please do not edit it. We're only looking for revisions to the items identified for Cure And changing anything else beyond deficient items may create confusion or introduce new deficiencies. In terms of how to show your edits. Please use strikethrough font for any language that is being deleted and no longer applies And use red font to identify all of your updates and additions so that reviewers can easily identify what has changed since the initial submission. Alternatively, plans may use revisions mode or track changes to identify all deleted and added language, tables, charts, or other information. If you reference an appendix or supporting document within the narrative, please denote this clearly within the model of care. Also, be sure to double check that all relevant links are operational before you submit. In terms of where to find guidance, your best starting point is the score down rationale provided in HPMS. This explanation should tell you exactly why each factor was scored as not met and should drive your revisions. Please also refer to the CY 2027 resources to support your work, including the scoring guidelines, Matrix, the FAQ, and the training recordings and slides posted on the NCQA SNP approval website. Next slide, please. This slide illustrates the formatting guidance we just covered by showing what a revised excerpt of a model of care response should look like. As a reminder, Strike Through Text identifies language that has been deleted, and red font identifies new or updated text. In this example for element 3B factor 1, you can see how the plan struck through the original language in the first sentence of the response to indicate that language is deleted and no longer applies They also use red font to add the two new sentences at the end of the response to provide additional detail. This is the level of clarity we are looking for. A reviewer should be able to look at your resubmission and immediately see what changed from your original documentation and understand why. Please use this example as a model as you mark up your own model of care revisions for the Cure this year. Next slide, please. Now that we've walked through the Cure submission requirements and how to format your revisions, we'll shift into a review of the scoring themes we saw most often for CY 2027. Over the next several slides, we'll focus on MOC 1A and MOC 1B. These were the most frequently failed elements this year, and a common reason plans were required to cure. For each element, we'll highlight the specific factor requirements and reminders to help you address the deficiencies cited in your NOID. Next slide, please. So we'll start off with element MOC 1A, which requires a description of both the general SNP population as well as the most vulnerable population. For this element, plans often missed factors two, three, and 4. First, we'll review some general information to keep in mind across the factors for this element, and then we'll drill down to the factor-specific requirements. In terms of general reminders for MOC 1A, please be sure that you provide data and information specific to the target population for the service areas served under the contract. We are looking for specific information, details, and data related to both the general and most vulnerable populations for the specific SNP type in detail, rather than general statements. Please also note that SNPs renewing their contracts after year two of operations must provide their own historical data instead of other local, national, or proxy data. That is, the expectation is that renewing plans submit SNP specific membership data rather than proxy data. That said, if you are an initial plan not yet in operation or a renewal plan that just began operations January 1st of this year Or a renewal plan with very limited or no membership, the use of proxy data in MOC 1A is acceptable. However, the use of proxy data must be stated explicitly and accompanied by a rationale for why proxy data is being used And why it is expected that the proxy data will reflect characteristics of the intended membership, both the general and most vulnerable populations. Lastly, we want to stress that all data must be recent, that is, from within the last three years, so that there is some assurance that it is still relevant and applicable. Do not use data prior to 2022. If outdated data is included to describe the current SNP target population, the intent of the factor is considered not met. Also, please be sure to date the data provided as well as indicate the data source. We'd also like to emphasize that plans should not submit the identical documentation by SNP detail for corporate entity submissions without customizing information for that specific population. The model of care submitted for a unique combination of the contract number, SNP type, and SNP detail must appropriately provide enrollee details for that particular SNP submission. For example, a model of care narrative should not be identical between a CSNP submission for diabetes, a CSNP submission for cardiovascular disorders, and a CSNP submission for chronic kidney disease. The verbiage should be customized to be specific to that population and their specific needs. Next slide, please So for factor two, this factor focuses on the demographics of both the general target population and the most vulnerable population. As part of this factor, a clear distinction between the demographics for these two populations must be made. Do not provide demographic information for the most vulnerable population that is identical to the demographic information provided for the general population. The plan must detail population demographic data, including but not limited to average age, sex, language spoken, education level, and socioeconomic status for both populations. Providing demographic data for only the general population and not the most vulnerable population was a common reason this factor was scored as not met. Again, these data must be differentiated between the general and most vulnerable populations. Not differentiating between the demographic profiles of these two populations was another common reason this factor was not met. All information provided must be specific to your population, your target population. Please be aware that plans in operations for two years must use their own data for both the general and most vulnerable populations. New plans or plans without enrollees may use enrollee information from other product lines or compile details from the intended plan service area as an example of the intended target population. In each of these scenarios, you need to make sure that you are providing data for both the general and the most vulnerable populations in your service area. You must also indicate that proxy data is being used, why it is being used, and specify the correlation between the proxy data and the target populations. Again, any SNP specific data used to describe the membership must be recent, again within the last three years. Data older than 2022 may not be used to meet this factor. And again, if outdated data is included to describe the general or the most vulnerable populations, the intent of the factor is considered not met. Along the same vein, please be sure to specify sources and dates for all data used, not indicating data sources and dates was also a reason that plans sometimes did not meet factor too Please remember that there are a variety of components within Factor II that must be addressed to receive credit. Next slide, please. So this slide shows an example of how plans might address the provision of demographic data to address factor two. Plans may present the required demographic information in different ways. The most common is a table breaking down age, sex, language spoken, education and socioeconomic status for each service area. For example, by county or state, and for each population. Be sure to include data for both the general and most vulnerable population for each service area the SNP covers. If any area is missing, the factor is not considered fully met. So, for instance, a plan serving Ohio, Indiana, and Kentucky must provide details for all 3 states. Beyond providing demographic data, the plan must differentiate the general and most vulnerable populations. Alternatively, a detailed narrative is also acceptable in place of a table, as long as it carries the same level of demographic data detail for both populations and differentiates them from each other. Again, please be sure to date the data and provide the data source as is done in the tagline under this example table on the slide. Next slide, please. For factor three, the model of care must describe the target population's specific health characteristics for both the general and most vulnerable populations, including a description of the current health status of its SNP enrollees and a review of relevant diseases and comorbidities The SNP must indicate the incidence and prevalence of major diseases and chronic conditions that impact these populations. Additionally, the model of care must address social, cognitive, environmental factors and living conditions associated with the general and most vulnerable SNP populations. The plan must provide data for these health status parameters for both the general and most vulnerable populations and differentiate health status between the populations across the specified categories. Please be sure to provide plan data rather than providing general statements. Common reasons that plans did not meet Factor 3 were not including plan data for these categories Only including data for the general population and not the most vulnerable population And not differentiating the health status profile between the two populations. Again, please note that SNPs renewing their contracts after year two of operations must provide their own historical data instead of other local, national, or proxy data. Similar to factor two, proxy data may be provided for new plans, renewal plans just beginning operations this year, or renewal plans with no or limited membership. However, again, the use of proxy data must be explicitly stated along with the rationale for use And the reason that the plan believes the proxy data approximates the intended general and most vulnerable target populations. And again, all membership data must be current and cannot be from earlier than 2022 and data sources must be labeled. Next slide. Finally, for factor 4, plans must describe the conditions and other factors impacting enrollee health and the actions taken to address these needs. This includes providing data on factors such as language barriers, gaps in health literacy, poor socioeconomic status and housing, food and transportation insecurity As well as cultural beliefs or barriers and caregiver considerations. And this is for both the general and most vulnerable populations. As with the earlier factors, be sure to differentiate between the two populations, describe how these factors contribute to health disparities and the challenges they pose, and explain how the SNP addresses the needs for both populations. Again, please note for contract year 2027 membership data prior to 2022 cannot be used. Next slide. So now that we've reviewed MOC 1A, we're going to move into MOC 1B, which addresses the services provided for your most vulnerable enrollees. For Factor I, the SNP must describe the internal process or methodology used to identify the most vulnerable SNP enrollees. For example, the plan might use data collected on multiple hospital admissions within a specified timeframe High pharmacy utilization, specific diagnoses, or documented medical, psychosocial, cognitive, or functional challenges To meet Factor 1, the model of care must detail the specific criteria used to determine whether an enrollee is considered part of the most vulnerable population. Plans should avoid general statements and share the specific criteria used to identify the most vulnerable members. For example, the specific count of chronic conditions, number of medications, a specific diagnosis or set of diagnoses, or count of specific events within a timeframe, such as the number of hospitalizations during a defined period. We will provide an example of this on the next slide. A common reason this factor with Scored is not met was due to the provision of general versus specific inclusion criteria. The plan must differentiate between the most vulnerable enrollees and the general population that is considered lower risk and less resource intensive. For factor two, the SNP must describe the specially tailored care management practices used for the most vulnerable enrollees and detail the additional benefits available to this group beyond what the general population receives. Be specific about these tailored services and benefits, and address how the SNP will meet the needs of the most vulnerable enrollees across the full continuum of care, including end-of-life considerations. Plans must address how they meet or intend to meet the unique needs of their most vulnerable enrollees through the provision of tailored services and care management processes. We want to understand what you are doing on your end to support these individuals beyond the general population. Some examples of specially tailored services may include transportation services, healthy food and produce benefits, specific social services, and advanced care planning. Care management practices may entail more frequent connection with the enrollee by the care manager based on the enrollee's higher acuity, leading to more frequent individualized care plan updates and connection with the interdisciplinary care team. If plan services and benefits are not reserved only for the most vulnerable population, then plans may identify services and benefits that may not necessarily be exclusive to the most vulnerable population, but that would be highly beneficial for and are frequently used by that population. In this instance, please state this specifically in the model of care response As a note, both MOC 1A factor 4 and MOC 1B factor 2 Ask about how the SNP addresses the needs of the most vulnerable with services and actions. The difference between these two factors is that MOC 1A factor 4 requires a description of conditions and/or other factors impacting SNP enrollees For both the general and most vulnerable populations, including how the snippet addresses these needs. For MOC 1b factor 2, the MOC must describe in detail the specially tailored care management practices and services used to support enrollees considered especially vulnerable. Next slide, please. This slide provides an example of the specific criteria used to identify the most vulnerable members under Factor 1 of this element As you can see in this example, the health plan provided a number of specific characteristics and criteria used to determine the most vulnerable population. We have bolded these criteria in red font, which include characteristics such as four or more chronic medical and or behavioral conditions frequent trips to the ER, specifically more than three times a year Complex medication regimens, specifically more than eight prescriptions Limitations in at least 3 activities of daily living, and less than a high school education. In addition, the plan notes that this population also includes any enrollees experiencing homelessness, as well as any enrollees diagnosed with ESRD. Again, please be sure that you define the inclusion criteria specifically, that as you can see here that the plan indicated more than eight prescriptions rather than just high prescription usage. We're looking for this level of detail and specificity in your response. Next slide, please. For Factor III, SNPs must describe their established partnerships with community organizations that provide, facilitate, or assist in identifying resources for the most vulnerable enrollees and their caregivers. As part of this response, the plan must also describe how the SNP collaborates with its partners to facilitate access to community services deliver needed services, and maintain continuity of services for the most vulnerable enrollees and their caregivers. Plan should also describe how they support and or maintain these partnerships over time While CMS and NCQI are not prescriptive in how a plan specifically demonstrates collaboration with community partners, plans should describe how they work with their partners to facilitate access, deliver needed community services, and maintain continuity of services for this most vulnerable population Plans must also include a list of current community partnerships specific to the SNP service area and the associated services they provide to the most vulnerable enrollees. Again, these services should be specific to the service area. That is, we expect some level of customization across different submissions from the same corporate plan based on service area and enrollee needs. The list of community partnerships should be distinct from any benefits providers identified in the plan's response to Factor 2. Common reasons that this factor was scored as not met include not providing a list of community resources available to the most vulnerable enrollees and their caregivers. not describing the services the community resources provide Not including surface area specific resources And not addressing the establishment and maintenance of these community partnerships For factor 4, SNPs must describe and explain any challenges associated with the establishment of partnerships with community organizations that impact the ability to connect enrollees to specific community services. For example, limited community resource capacity, geographic access issues. administrative barriers information sharing or coordination challenges, etc. Beyond describing these challenges, the response must also include a description of the strategies and solutions that the SNP uses or plans to use to mitigate these challenges. The most common reason that this factor was scored is not met were primarily due to plans not clearly identifying the strategies and solutions they will implement to address the noted challenges. In addition, some plans did not provide challenges associated with community partnership establishment, but rather only included enrollee level barriers. Please be mindful to provide challenges related to the establishment of community partnerships and to include associated mitigation strategies for the challenges identified to meet the requirements of Factor 4. And that brings us to the end of our review of Elements MOC 1A and 1B. So with that, let's move on to the next slide, please. All right, well that concludes our planned content related to the cure for contract year 2027 We'll now open it up for any questions that you may have Feel free to raise your hand to ask your question live or to submit questions via the Q&A feature. Okay, we have a hand up And you should now be able to unmute to ask your question. Thank you. Can you hear me? Yes, we can hear you. Okay, good, good afternoon. So just a quick question. When we are looking at the whole population And then we segment the highest risk out the most vulnerable. The remaining is the general population what remains or do you see the general population to include the whole total enrollment or those that remain after we segment the high risk out Because I'm getting, one of my report writers is saying that it's the whole… the general population is the whole But I'm thinking that once I segment out the highest risk, it's the remaining that I'm doing the comparison to. To me, that made more sense. Yeah, thank you so much for your question. NCQA and CMS are not prescriptive in how this is broken out. Some plans handle it in that the general population includes all members, those that are not the most vulnerable, and those that are the most vulnerable And some plans include in their general population those members minus the most vulnerable population, but that's not something that NCQ and CMS specify. However, for the most vulnerable population, that would be just those individuals in the data associated with them for that specific segment that you've identified as being, you know, needing more resources, being more vulnerable according to the inclusion criteria that you describe in MOC One B factor one. Okay, thank you. Thank you for your question. And Laura, it looks like we have a few in the Q&A, so I can queue them up If we have no more raised hands Let's thanks, Sri, let's give it a moment to see if there are more questions, live questions. Okay, we have another hand up. Just a moment. All right, you should now be able to unmute. Pause, you should be able to unmute. Okay. Yes, we can hear you. Yes. You guys hear me? Yeah, I just had a question. So we're in the process of launching two new SNP conditions. So we wouldn't have any member population regarding those And then we also have a group for pairing. So I guess the confusion is when we do submit our mocks, are the requirements to include a MOC for each condition. So we would submit five mocks or is it okay if we submit one MOC For one group pairing which we did in the past, and two additional ones for the new conditions that we'd like to get approved. Thank you so much for your question. We appreciate that. So the model of each model of care submission should be specific to the contract number, the SNP type, as well as the SNP detail or condition. So, it sounds like you mentioned there 5 different C snips conditions. The expectation would be that you would submit 5 separate model of care submissions to represent each one of those CSNP specific conditions. You also noted that did you mention that there are two new offerings. Yeah, so one is there's three conditions that are considered a group four pairing Yeah And then we're offering potentially two new additional conditions, which are separate. So I would assume that would be three submissions for MOC, but it looks like from what you're saying is regardless if they're group four pairing they would be considered each individual conditions you need to submit like cardiovascular. Okay. That's correct. Yes. Thank you for the clarification. And then in case it's helpful for the new offerings For the data provided, again, as noted sort of earlier on, excuse me, in the webinar Plans that are offering an initial model of, you know SNP or those that are renewing with either limited or no membership or that just began operations earlier this year. It is acceptable to provide proxy data However, the distinction just needs to be made that the data provided is proxy data. Why that data is being provided, as well as why the organization believes that the data provided will represent or characterize and approximate the demographic information of their intended target populations, both the general and the most vulnerable. Got it. So, excuse me, for these two new conditions, although we're renewing from a previous SNP approval, we're offering two new conditions, and then we don't have a patient population for that, so we can use proxy data for the general population and potentially the most vulnerable population Yes, that's correct. Okay, thank you. Thank you so much for your questions. Okay, we have another hand up, just a moment. Okay, you should be able to unmute. Thank you. I just have one more question. So our dashboards that we get our data from update Is there a restriction? Can I use the most recent data available or does it have to be prior to the May deadline of the original submission? Thank you for your question. You can use the most recent data available. Thank you. Oh, thank you so much. Appreciate that. Yes, of course. We have a hand up, just a moment All right, Kim, you should be able to unmute. Hi, thank you. So if the cure was only for Mach 1A, would the submission simply be that 1A, or would you re-upload the entire model of care? Yeah, thank you for your question. So You would need to resubmit the entire model of care narrative and then You mentioned MOC 1A. You would correct any deficiencies within MOC one using the process that we reviewed previously. So using either track changes or revisions mode Or using strikethrough language to remove text that no longer applies in red font to add any new text or detail. And then you would also go ahead if you'd like to, any other factors outside of MOC 1A that are scored as not met, you are also able to revise. in that same sort of track change process. Okay, understood. Thank you. Thank you so much. And I guess I should mention the same bodes true with Truth revision modes or strikethrough text for the matrix as well. We'll have a few moments. Let's see if there are other hands We have a hand up just a moment. Hi, this sorry I had another question. So let's say for each of the elements So let's say MOC 1, you failed, Mach 2 you failed, but Mach 3 and 4, you pass, but some of the factors were not met and you did get overall passing score. What are the requirements for the resubmission? Do you guys expect all the unmet factors to be revised, or just the one… the MOCs that were failing Thank you. We try to say Thank you for your question. So really it's to the discretion of the plan in terms of whether you'd like to revise the factors scored as not met outside of elements that did not meet the minimum scoring threshold Within the elements that did not meet the minimum scoring threshold, we would recommend that you revise all of the factors included there to increase the likelihood of obtaining the 50% minimum scoring threshold In terms of the factors outside of elements that did not meet the minimum scoring threshold that have factors that they're not met, we would also encourage plans to revise those If able to, because for off-cycle reviews, if there are outstanding factors scored as not met and you submit an off-cycle evaluation with revisions to an element that has factor score is not met. If you don't also revise those, that impacts sort of the off-cycle result status. So we would encourage plans to revise all factors. Scored is not met. However, that is not a requirement Thank you. Other questions Looks like there's a question in the chat that we'd like to take live. Yes, I can go ahead and cue that up. The question says, we have previously submitted one MOC for group 4. You're now telling us that we need to submit 3 separate MOCs for this grouping. This conflicts with the previous NTQA advice. Yeah, and I'd say, I think, appreciate the question. I think maybe there's some confusion there. So we have clarified and specified in FAQs both this year and in the past That SNPs must submit a separate model of care for each SNP type and detail. So each subtype under a particular contract And so a single model of care cannot be submitted for multiple SNP types or subtypes under one contract, and that does still stand. So I want to clarify that piece. And I welcome any additional comment or information from my CMS colleagues. Thanks, Laura. So to play out that example, what you're sharing is that, for example, you cannot submit a mock for both a DSTIP and a CSNP plan offering. However, if you have multiple DSNP offerings where the MOC is sort of appropriate, you can submit one DSNP mock. Correct. That's my understanding. But the question, I think was more related to the chronic conditions. If I'm not mistaken. That's… yes, that's what I'm gathering as well. It looks to be specifically about group four. And so it's sort of been the requirement, both in the past and now to submit a separate model of care and individual model of care for each H contract number each combination of each contract number Plan type, so CSNP, DNP or is SNP And detail or subtype. So We would, you know, expect a If I guess to clarify, if you are offering a CSNP detail of diabetes, cardiovascular disorder, and chronic heart failure And it's one SNP, then one submission is appropriate. However, if you are offering three different SNPs, one that is diabetes, one that is chronic heart failure, and one that is cardiovascular disorder We would expect that there be three separate submissions for those three SNPs So hopefully that clarifies and gets the question Are there any follow-up questions on that? Any additional questions that attendees would like to pose live? And Thor, it looks like we have one more clarifying question in the Q&A related to the one you just answered. It says, so if it's a CSNP Group 4, it is one MOC, not a separate MOC For each condition in the group. If you are a SNP offering have one application in CMS that is for diabetes, chronic heart failure, and cardiovascular disorder, then you would submit one model of care. If you have three separate applications for the component conditions, you would submit 3 separate models of care. Questions Do we have any raised hands or questions in the chat? Madeline or Sheri, any questions that you see? No raised hands and no questions in the chat at this time. Thank you for the question in the chat about the rest period given next week's curing deadline. We are working to respond to inquiries within 48 hours. If you do not receive a response by then, please To send a follow up and we'll make sure we get to you. Hope that helps. Thank you, Emily. Any other questions? I don't see any hands raised or anything in the chat, so we'll give it a another minute or so to see if there are any Any other questions that the group would like to pose before adjourning Well, seeing no hands raised and nothing in the chat, I think we can go ahead and adjourn for today. So we'd like to certainly thank you for your time and attention during this afternoon's technical assistance call for contract year 2027 CARE submissions We appreciate it. And this concludes today's session. Thank you so much. Take care.