CFR /  Title 42  /  Part 425: Medicare Shared Savings Program

Section No.	Description
Section 425.10	Definitions
Section 425.20	General
Section 425.100	Eligible providers and suppliers
Section 425.102	Legal entity
Section 425.104	Shared governance
Section 425.106	Leadership and management
Section 425.108	Number of ACO professionals and beneficiaries
Section 425.110	Required processes and patient-centeredness criteria
Section 425.112	Participation in other shared savings initiatives
Section 425.114	Agreements with ACO participants and ACO providers/suppliers
Section 425.116	Required reporting of ACO participants and ACO providers/suppliers
Section 425.118	Participation agreement with CMS
Section 425.200	Application procedures
Section 425.202	Content of the application
Section 425.204	Evaluation procedures for applications
Section 425.206	Provisions of participation agreement
Section 425.208	Application of agreement to ACO participants, ACO providers/suppliers, and others
Section 425.210	Changes to program requirements during the agreement period
Section 425.212	Managing changes to the ACO during the agreement period
Section 425.214	Actions prior to termination
Section 425.216	Termination of the participation agreement by CMS
Section 425.218	Termination of the participation agreement by the ACO
Section 425.220	Close-out procedures and payment consequences of early termination
Section 425.221	Re-application after termination
Section 425.222	Renewal of participation agreements
Section 425.224	Compliance plan
Section 425.300	Program requirements for data submission and certifications
Section 425.302	Other program requirements
Section 425.304	Participant agreement and exclusivity of ACO participants
Section 425.306	Public reporting and transparency
Section 425.308	Marketing requirements
Section 425.310	Notification to beneficiaries of participation in shared savings program
Section 425.312	Notification to beneficiaries of participation in the shared savings program
Section 425.312	Audits and record retention
Section 425.314	Monitoring of ACOs
Section 425.316	General
Section 425.400	Criteria for a beneficiary to be assigned to an ACO
Section 425.401	Basic assignment methodology
Section 425.402	Special assignment conditions for ACOs including FQHCs and RHCs
Section 425.404	Measures to assess the quality of care furnished by an ACO
Section 425.500	Calculating the ACO quality performance score
Section 425.502	Incorporating reporting requirements related to the Physician Quality Reporting System Incentive and Payment Adjustment
Section 425.504	Incorporating reporting requirements related to adoption of Electronic health records technology
Section 425.506	Selection of risk model
Section 425.600	Establishing, updating, and resetting the benchmark
Section 425.602	Calculation of savings under the one-sided model
Section 425.604	Calculation of shared savings and losses under Track 2
Section 425.606	Determining first year performance for ACOs beginning April 1 or July 1, 2012
Section 425.608	Calculation of shared savings and losses under Track 3
Section 425.610	Waivers of payment rules or other Medicare requirements
Section 425.612	General rules
Section 425.700	Aggregate reports
Section 425.702	Beneficiary-identifiable data
Section 425.704	Minimum necessary data
Section 425.706	Beneficiaries may decline data sharing
Section 425.708	Beneficiaries may decline claims data sharing
Section 425.708	Data use agreement
Section 425.710	Preclusion of administrative and judicial review
Section 425.800	Request for review
Section 425.802	Reconsideration review process
Section 425.804	On-the-record review of reconsideration official's recommendation by independent CMS official
Section 425.806	Effect of independent CMS official's decision
Section 425.808	Effective date of decision
Section 425.810	Basis and scope