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Increasing Organ Transplant Access (IOTA) Model

How does participation in the IOTA Model work?

• This model focuses on providing incentives to selected kidney transplant hospitals to increase transplantation and is designed to support greater care coordination, improved patient-centeredness in the process of being waitlisted for and receiving a kidney transplant, and greater access to kidney transplants.
• Through the IOTA Model payments and policies, CMS aims to increase the care delivery capabilities and efficiency of kidney transplant hospitals selected for participation, with the goal of improving quality of care while reducing unnecessary spending. The IOTA Model only affects payments in Original Medicare and does not affect payments or services for Medicare Advantage Plans, Medicare Prescription Drug Plans, or private health insurance plans.

How does the IOTA Model affect me, the Medicare patient?

• As a patient, the IOTA Model does not change your existing Medicare benefits, choices, or protections. We cannot limit your choice of health care providers or Medicare-covered medically necessary services or treatment options. You still have the right to visit any doctor, hospital, or other provider that accepts Original Medicare at any time, just like you do now.

What information will be shared about me?

• Medicare shares information about your care with your health care providers such as dates and times you visited a health care provider and your medical conditions. Sharing your data helps make sure all the providers involved in your care have access to your health information when and where they need it.
• We value your privacy. IOTA participants must put important safeguards in place to make sure all your health care information is safe. We respect your choice on how your health care information is used for care coordination and quality improvement
• If you don't want Medicare to share your health care data information, call 1-800-MEDICARE (1-800-633-4227). Tell the representative that your health care provider is part of the IOTA Model, and you don't want Medicare to share your health care information. Beneficiaries who are deaf, hard of hearing, deaf-blind, or have speech disabilities should call 1-877-486-2048.

How can I make the most of getting care from the IOTA Model?

• As a Medicare patient, you can choose or change your provider at any time. Your nephrologist is the health care provider responsible for coordinating your overall care for your kidney-related disease. Your nephrologist can help you make informed decisions about your health care, track your treatment, and monitor your health outcomes.

What if l have concerns about being part of the IOTA Model?

• If you have questions or concerns about the quality of care or other services you receive from your provider, you can contact 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. You may also visit the website: https://www.Medicare.gov.
• If you suspect Medicare fraud or abuse from your IOTA provider or any Medicare provider, we encourage you to make a report by contacting the HHS Office of Inspector General (1-800-HHS-TIPS).
• If you believe your privacy rights have been violated, you may file a privacy complaint with CMS (visit Medicare.gov, or call 1-800-MEDICARE) or with the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (visit hhs.gov/hipaa/filing-a-complaint). Filing a complaint won't affect your coverage under Medicare.