42 CFR 425.104
§ 425.104 Legal entity.
United States · 42 CFR — Public Health · Status: effective
Cite this
- Citation
- 42 CFR 425.104, § 425.104 Legal entity, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/205276
- Permanent ID
ys:prov:205276@1- SHA-256
c625465c6206968c5ceda39a8ac1d242e94bc6eeaec43c6582a5f66eaf84ec88
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
(a) An ACO must be a legal entity, formed under applicable State, Federal, or Tribal law, and authorized to conduct business in each State in which it operates for purposes of the following:
(1) Receiving and distributing shared savings.
(2) Repaying shared losses or other monies determined to be owed to CMS.
(3) Establishing, reporting, and ensuring provider compliance with health care quality criteria, including quality performance standards.
(4) Fulfilling other ACO functions identified in this part.
(b) An ACO formed by two or more ACO participants, each of which is identified by a unique TIN, must be a legal entity separate from any of its ACO participants.
(c) An ACO formed by a single ACO participant may use its existing legal entity and governing body, provided it satisfies the other requirements in §§ 425.104 and 425.106.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.