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The proposed Health Equity Benchmark Adjustment (HEBA) described in section III.G.7.b of this proposed rule would add a third avenue for ACOs to receive a positive adjustment to their historical benchmark, and would be most impactful for new ACOs serving medically complex, high-cost populations in underserved communities

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In addition to manufacturer-initiated corrections, CMS may become aware of manufacturer misreporting based on fact finding and conclusions of enforcement authorities, for example, the HHS Office of Inspector General, the CMS Center for Program Integrity, or the Department of Justice

Patients with significant valvular heart disease of more than moderate to severe, hypertrophic cardiomyopathy, restrictive cardiomyopathy, prior cardiac surgery, or structural heart disease were excluded