Withings Medical Group

ACCESS Program Beneficiary Notice

Form Effective: July 06, 2026 · Version 2026-07-06

1. About ACCESS

ACCESS is a CMS Innovation Center (CMMI) program for chronic care management. It connects you with a dedicated care team that monitors your health between doctor visits using connected Withings devices (blood pressure monitor, smart scale). Your care team uses your readings to catch problems early, coordinate your care, and keep you on track with your health goals.

Participation in ACCESS is completely voluntary and costs you nothing. All patient fees under this model have been waived by CMS.

2. Medicare Eligibility Confirmation

After you submit your enrollment, Withings Medical Group confirms your eligibility directly with Medicare. This confirmation is not instant — it can take a little time. We'll keep you updated on the status of your enrollment as soon as Medicare confirms.

3. Voluntary Participation & Right to Opt Out

Your participation in ACCESS is voluntary. You are choosing to enroll of your own free will. You may opt out of ACCESS at any time by contacting your care team or calling (888) 854-7196. Your opt-out will be processed per CMS alignment rules. Opting out will not affect your Medicare benefits or your ability to receive care from any provider.

4. Freedom of Provider Choice

Enrolling in ACCESS does not restrict your choice of healthcare providers. You may continue to see any Medicare-participating doctor, specialist, or facility you choose. Your alignment with ACCESS is for care coordination purposes only.

5. No Cost to You

All patient fees under the ACCESS model have been waived. You will not owe any copays, coinsurance, or out-of-pocket costs for ACCESS services. Your regular Medicare benefits and any costs associated with non-ACCESS services remain unchanged.

6. Health Data Collection & Use

As part of ACCESS, we will collect health readings from Withings devices provided to you (blood pressure, weight, heart rate, and related measurements). This data is used by your care team to:

All health data is stored and transmitted in compliance with HIPAA (Health Insurance Portability and Accountability Act). Your data is used for treatment, payment, and healthcare operations (TPO) and is shared only among your ACCESS care team members for the purpose of coordinating your care.

7. CMS Claims Data Sharing

CMS (Centers for Medicare & Medicaid Services) may share your Medicare claims data with your ACCESS care team to improve care coordination. This includes information about visits, procedures, and medications from other Medicare providers.

You have the right to opt out of claims data sharing at any time. Opting out of claims data sharing will not affect your participation in ACCESS or your Medicare benefits. To opt out, contact your care team or call (888) 854-7196.

8. Communications

You may receive text messages (SMS), emails, and phone calls from your ACCESS care team with:

You can opt out of SMS at any time by replying STOP to any message. Email and phone preferences can be updated by contacting your care team. See also the Consent to Electronic Communication.

How this document is agreed to

This document is provided and agreed to electronically as part of enrollment in the ACCESS program of Withings Medical Group. There is no handwritten signature. You indicate your agreement by checking the box for this document and typing your full name on the consent step of enrollment.

Withings Medical Group keeps a record of your typed name, the date and time of your agreement, and the version of this document that was shown to you. Under the federal Electronic Signatures in Global and National Commerce Act (ESIGN Act) and applicable state Uniform Electronic Transactions Act (UETA) laws, this electronic agreement is as valid as a handwritten signature.

If you are completing enrollment on behalf of the patient, you confirm that you are the patient's legal guardian, health care agent, or other personal representative authorized under applicable law to act for the patient, and that you are agreeing in that capacity.

You may request a paper copy of this document, or ask questions about it, at any time by calling (888) 854-7196 or writing to Privacy@withings.com. You may opt out of the ACCESS program at any time — see "Voluntary Participation & Right to Opt Out" above.