Subpart G—Shared Savings and Losses

1. CFR
2. ›
3. Title 42
4. ›
5. Chapter IV
6. ›
7. Part 425
8. ›
9. Subpart G

Sections

• 425.600
  § 425.600 Selection of risk model.
• 425.601
  § 425.601 Establishing, adjusting, and updating the benchmark for agreement periods beginning on or after July 1, 2019, and before January 1, 2024.
• 425.602
  § 425.602 Establishing, adjusting, and updating the benchmark for an ACO's first agreement period beginning on or before January 1, 2018.
• 425.603
  § 425.603 Resetting, adjusting, and updating the benchmark for a subsequent agreement period beginning on or before January 1, 2019.
• 425.604
  § 425.604 Calculation of savings under the one-sided model.
• 425.605
  § 425.605 Calculation of shared savings and losses under the BASIC track.
• 425.606
  § 425.606 Calculation of shared savings and losses under Track 2.
• 425.608
  § 425.608 Determining first year performance for ACOs beginning April 1 or July 1, 2012.
• 425.609
  § 425.609 Determining performance for 6-month performance years during CY 2019.
• 425.610
  § 425.610 Calculation of shared savings and losses under the ENHANCED track.
• 425.611
  § 425.611 Adjustments to Shared Savings Program calculations to address the COVID-19 pandemic.
• 425.612
  § 425.612 Waivers of payment rules or other Medicare requirements.
• 425.613
  § 425.613 Telehealth services.
• 425.614-425.629
  §§ 425.614-425.629 [Reserved]
• 425.630
  § 425.630 Option to receive advance investment payments.
• 425.631-425.639
  §§ 425.631-425.639 [Reserved]
• 425.640
  § 425.640 Option to receive prepaid shared savings.
• 425.641-425.649
  §§ 425.641-425.649 [Reserved]
• 425.650
  § 425.650 Benchmarking methodology.
• 425.652
  § 425.652 Establishing, adjusting, and updating the benchmark for agreement periods beginning on January 1, 2024, and in subsequent years.
• 425.654
  § 425.654 Calculating county expenditures and regional expenditures.
• 425.655
  § 425.655 Calculating the regional risk score growth cap adjustment factor.
• 425.656
  § 425.656 Calculating the regional adjustment to the historical benchmark.
• 425.658
  § 425.658 Calculating the prior savings adjustment to the historical benchmark.
• 425.659
  § 425.659 Calculating risk scores used in Shared Savings Program benchmark calculations.
• 425.660
  § 425.660 Accountable Care Prospective Trend (ACPT).
• 425.661
  § 425.661 [Reserved]
• 425.662
  § 425.662 Calculating the population adjustment to the historical benchmark.
• 425.663-425.669
  § 425.663-425.669 [Reserved]
• 425.670
  § 425.670 Adjustments to mitigate the impact of significant, anomalous, and highly suspect billing activity on Shared Savings Program financial calculations involving calendar year 2023.
• 425.672
  § 425.672 Adjustments to mitigate the impact of significant, anomalous, and highly suspect billing activity on Shared Savings Program financial calculations involving calendar year 2024 or subsequent calendar years.
• 425.674
  § 425.674 Accounting for the impact of improper payments on Shared Savings Program financial calculations.