Table 3.

Conditions of Accountability for Reasonableness framework

Condition	Description
Publicity	Limit-setting decisions and their rationales must be publicly accessible.
Relevance	These rationales must rest on evidence, reasons, and principles that fair-minded parties (managers, clinicians, patients, and consumers in general) can agree are relevant to deciding how to meet the diverse needs of a covered population under necessary resource constraints.
Appeals	There is a mechanism for challenge and dispute resolution regarding limit-setting decisions, including the opportunity for revising decisions in light of further evidence or arguments.
Enforcement	There is either voluntary or public regulation of the process to ensure that the first three conditions are met.