(a) ASM beneficiary incentives. ASM participants may choose to provide in-kind patient engagement incentives, including but not limited to items of technology or services, to ASM beneficiaries, subject to the following conditions:

1. (1) Provision of incentive.

   1. (i) The incentive must be provided directly by the ASM participant or by an agent of the ASM participant under the ASM participant's direction and control to an ASM beneficiary who is an established patient of the ASM participant.
   2. (ii) The ASM participant must be solely responsible for any costs associated with the provision of the incentive, including but not limited to, the retail value of the item or services offered as the ASM beneficiary incentive.
2. (2) The item or service provided must be reasonably connected to medical care provided by the ASM participant to an ASM beneficiary for an ASM targeted chronic condition.
3. (3) The item or service must be a preventive care item or service or an item or service that advances a clinical goal, as specified in paragraph (d) of this section, for an ASM beneficiary by engaging the ASM beneficiary in better managing an ASM targeted chronic condition.
4. (4) The item or service must not be tied to the receipt of items or services outside the services furnished by the ASM participant to the ASM beneficiary.
5. (5) The item or service must not be tied to the receipt of items or services from a particular provider or supplier.
6. (6) The availability of the items or services must not be advertised or promoted, except that an ASM beneficiary may be made aware of the availability of the items or services at the time the ASM beneficiary could reasonably benefit from them.
7. (7) The cost of the items or services must not be shifted to any Federal health care program, as defined at section 1128B(f) of the Act.
8. (8) The totality of items or services, including technology as described at paragraph (b) of this section, provided to an ASM beneficiary may not exceed $1,000 in retail value for any one ASM beneficiary.

(b) Technology provided to an ASM beneficiary. ASM beneficiary incentives involving technology are subject to the following additional conditions:

1. (1) Items or services involving technology provided to an ASM beneficiary must be the minimum necessary to advance a clinical goal, as listed in paragraph (d) of this section, for an ASM beneficiary.

2. (2) Items of technology exceeding $75 in retail value must—

   1. (i) Remain the property of the ASM participant; and

   2. (ii) Be retrieved from the ASM beneficiary—

      1. (A) Upon the end of their care relationship with the ASM participant, with documentation of the ultimate date of retrieval. The ASM participant must document all retrieval attempts.

         (1) In cases when the item of technology is not able to be retrieved, the ASM participant must determine why the item was not retrievable.

         (2) If it was determined that the item was misappropriated, then the ASM participant must take steps to prevent future beneficiary incentives for that ASM beneficiary.

         (3) Following this process, documented, diligent, good faith attempts to retrieve items of technology is deemed to meet the retrieval requirement; or

      2. (B) If the provided technology breaks or is otherwise rendered unusable for its intended purposes, with documentation of the ultimate date of retrieval. The ASM participant may replace the unusable unit with the same or similar technology, to the extent practicable, that meets the requirements of paragraphs (a) and (b) of this section.

(c) Documentation of ASM beneficiary incentives. In addition to requirements at § 512.135 of this part ASM participants must do all of the following:

1. (1) Maintain documentation of items and services furnished as beneficiary incentives that exceed $75 in retail value.

2. (2) The documentation must be established contemporaneously with the provision of the items and services with a record established and maintained to include at least the following:

   1. (i) The date the incentive is provided.
   2. (ii) The identity of the ASM beneficiary to whom the item or service was provided.
3. (3) The documentation regarding items of technology exceeding $75 in retail value must also include contemporaneous documentation of any attempt to retrieve technology at the end of an episode, or why the items were not retrievable, as described in paragraph (b)(2)(ii) of this section.
4. (4) The ASM participant must retain and provide access to the required documentation.

(d) Clinical goals of ASM. The following are the clinical goals of ASM, which may be advanced through ASM beneficiary incentives:

1. (1) Promoting preventive care through improved management of ASM targeted chronic conditions.
2. (2) Empowering patients to actively participate and be accountable for quality and whole health outcomes.
3. (3) Facilitating meaningful and efficient coordination between specialists and primary care providers to increase independent physician participation in value-based payment programs.