{
  "schema_version": "1.0",
  "generated_on": "2026-09-03",
  "objects": [
    {
      "slug": "fda-tempo",
      "title": "FDA TEMPO Participant Status | Prevention for Longevity",
      "h1": "FDA TEMPO participant status",
      "eyebrow": "Stable knowledge object · FDA TEMPO",
      "summary": "FDA states that effectiveness for the participating intended uses has not yet been evaluated. FDA's maintained TEMPO participant table currently lists four participants: SonderMind, Inc. / SonderMind Adjunctive Care Application (SACA); Limbic Inc. / Unpacked; Cadence Solutions, Inc. / HypertensionOS; and Dexcom, Inc. / Dexcom Glucose Health Program.",
      "status": "Current but high-volatility",
      "sources": [
        "https://www.fda.gov/medical-devices/digital-health-center-excellence/participants-selected-tempo-digital-health-devices-pilot"
      ],
      "establishes": [
        "The maintained FDA participant table currently lists SonderMind, Inc. / SonderMind Adjunctive Care Application (SACA).",
        "The maintained FDA participant table currently lists Limbic Inc. / Unpacked.",
        "The maintained FDA participant table currently lists Cadence Solutions, Inc. / HypertensionOS.",
        "The maintained FDA participant table currently lists Dexcom, Inc. / Dexcom Glucose Health Program."
      ],
      "does_not": [
        "FDA states that effectiveness for the participating intended uses has not yet been evaluated. Participation does not establish general FDA approval or clearance, Medicare coverage, endorsement, final CMS ACCESS participation, or scaled adoption."
      ],
      "interpretation": "P4L treats the maintained FDA participant table as the canonical source for present-state participation and keeps participant status separate from effectiveness, coverage, endorsement, and ACCESS participation.",
      "related": [
        [
          "/signal/2026-08-21-tempo-four-participants/",
          "Current signal record"
        ],
        [
          "/evidence/tempo-participants-2026/",
          "Evidence record EV-004"
        ],
        [
          "/proof/tempo-participants/",
          "Proof record CLM-0003"
        ],
        [
          "/intelligence-graph/",
          "Intelligence Graph"
        ],
        [
          "/brief/",
          "P4L Brief"
        ]
      ],
      "volatile": "tempo",
      "last_verified": "2026-09-03",
      "source_updated_at": "2026-08-21",
      "next_review_due": "2026-09-10"
    },
    {
      "slug": "cms-access",
      "title": "CMS ACCESS Model Status | Prevention for Longevity",
      "h1": "CMS ACCESS Model status",
      "eyebrow": "Stable knowledge object · CMS ACCESS",
      "summary": "CMS’s accepted-applicant page was updated August 17, 2026 and lists more than 150 accepted organizations. CMS says private payers representing 165 million members across Medicare Advantage, Medicaid, and commercial coverage have committed to align with the ACCESS payment approach, with many beginning in 2026. Inclusion on the accepted-applicant list is not CMS endorsement and does not guarantee final participation; participation remains contingent on Medicare enrollment, an executed agreement, final approval, and other requirements.",
      "status": "Current but high-volatility · source updated August 17, 2026",
      "sources": [
        "https://www.cms.gov/priorities/innovation/access-model-accepted-applicants",
        "https://www.cms.gov/priorities/innovation/innovation-models/access"
      ],
      "establishes": [
        "CMS’s accepted-applicant page was updated August 17, 2026 and lists more than 150 accepted organizations.",
        "CMS says private payers representing 165 million members across Medicare Advantage, Medicaid, and commercial coverage have committed to align with the ACCESS payment approach, with many beginning in 2026.",
        "CMS describes a ten-year model, rolling start dates, outcome-aligned payments, public reporting of aggregated risk-adjusted results, physician clinical oversight, clinical and data safeguards, and lifestyle/behavioral, diagnostic, medication, care-coordination, and technology-supported services."
      ],
      "does_not": [
        "CMS endorsement of an accepted organization.",
        "Guaranteed final participation, participant-specific effectiveness, coverage, outcomes, or performance."
      ],
      "interpretation": "P4L treats ACCESS as one monitored payment-and-adoption pathway. Accepted-applicant status, final participation, delivery, outcomes, and learning remain distinct decision states.",
      "related": [
        [
          "/proof/access-outcome-aligned-payment/",
          "Proof record CLM-0001"
        ],
        [
          "/proof/access-accepted-organizations/",
          "Proof record CLM-0002"
        ],
        [
          "/intelligence-graph/",
          "Intelligence Graph"
        ],
        [
          "/healthcare-innovation-adoption/",
          "Healthcare Innovation Adoption framework"
        ]
      ],
      "volatile": "access",
      "last_verified": "2026-09-03",
      "source_updated_at": "2026-08-17",
      "next_review_due": "2026-09-10"
    },
    {
      "slug": "arpa-h-prospr",
      "title": "ARPA-H PROSPR Healthspan Program | Prevention for Longevity",
      "h1": "ARPA-H PROSPR healthspan program",
      "eyebrow": "Stable knowledge object · ARPA-H PROSPR",
      "summary": "ARPA-H PROSPR funds multiple research teams to develop healthspan measures and accelerated trial approaches intended to make changes in healthspan measurable on practical research timelines.",
      "status": "Active R&D",
      "sources": [
        "https://arpa-h.gov/explore-funding/programs/prospr",
        "https://arpa-h.gov/news-and-events/research-teams-add-more-healthy-years-americans-lives-they-age"
      ],
      "establishes": [
        "ARPA-H is funding a PROSPR portfolio focused on healthspan measurement and accelerated research.",
        "The program includes distinct team-level approaches and milestones."
      ],
      "does_not": [
        "Successful validation of any healthspan endpoint or therapeutic claim before results establish it.",
        "Regulatory acceptance, reimbursement, or clinical adoption of a team’s approach."
      ],
      "interpretation": "P4L treats PROSPR as healthspan R&D infrastructure whose downstream importance depends on endpoint validation, trial results, regulatory translation, and institutional adoption.",
      "history": [
        "Program and award records retained as source-linked objects; milestones and results should be versioned as they change."
      ],
      "related": [
        [
          "/signal/2026-02-24-arpa-h-prospr-awards/",
          "PROSPR awards signal"
        ],
        [
          "/intelligence-graph/",
          "Intelligence Graph"
        ],
        [
          "/prevention-first-healthspan/",
          "Prevention-First Healthspan framework"
        ]
      ],
      "volatile": null
    },
    {
      "slug": "medicare-app-library",
      "title": "CMS Medicare App Library | Prevention for Longevity",
      "h1": "CMS Medicare App Library",
      "eyebrow": "Stable knowledge object · CMS Medicare App Library",
      "summary": "CMS publishes a voluntary Medicare App Library pathway for patient-facing apps that integrate with CMS Aligned Networks and meet one of three initial use cases. The pathway includes CMS-approved identity verification, independent vetting, interoperability, application materials, and CMS validation before listing.",
      "status": "Current published requirements · voluntary participation pathway",
      "sources": [
        "https://www.cms.gov/initiatives/health-technology-ecosystem/overview/submit-your-app/requirements-medicare-app-library",
        "https://www.cms.gov/initiatives/health-technology-ecosystem/overview/submit-your-app",
        "https://www.cms.gov/priorities/innovation/innovation-models/access"
      ],
      "establishes": [
        "CMS publishes a voluntary participation, evaluation, application, and listing pathway for patient-facing apps serving people with Medicare.",
        "The initial use cases are Kill the Clipboard, Conversational AI Assistants, and Diabetes & Obesity Prevention and Management.",
        "Published requirements address identity, interoperability, third-party evaluation, CMS review, and launch.",
        "ACCESS has a separate and conditional relationship to App Library review, designation, and payment."
      ],
      "does_not": [
        "Approval, acceptance, clinical effectiveness, Medicare coverage, payment, or CMS endorsement of a particular app.",
        "That the public pages checked contain every product-specific technical or evaluation threshold.",
        "That current requirements, partners, application access, listings, or ACCESS rules will remain unchanged."
      ],
      "interpretation": "P4L treats the App Library as a distribution and trust pathway that must be assessed together with identity, interoperability, evidence, privacy, usability, equity, CMS review, and any separate ACCESS eligibility.",
      "related": [
        [
          "/proof/medicare-app-library-use-cases/",
          "Proof record CLM-0005"
        ],
        [
          "/intelligence-graph/",
          "Intelligence Graph"
        ],
        [
          "/healthcare-innovation-adoption/",
          "Healthcare Innovation Adoption framework"
        ]
      ],
      "volatile": "medicare_app_library",
      "decision_object": {
        "canonical_record": "/data/v2/volatile-records.json",
        "record_key": "medicare_app_library",
        "object_id": "MAL-REQ-2026-09-03"
      },
      "maintenance": {
        "source_checked_on": "2026-09-03",
        "next_source_check": "2026-09-10"
      }
    }
  ]
}