42 CFR 425.202
§ 425.202 Application procedures.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 425.202, § 425.202 Application procedures, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/205286
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Full text
(a) General rules.
(1) In order to obtain a determination regarding whether it meets the requirements to participate in the Shared Savings Program, a prospective ACO must submit a complete application in the form and manner required by CMS by the deadline established by CMS.
(2) An ACO executive who has the authority to legally bind the ACO must certify to the best of his or her knowledge, information, and belief that the information contained in the application is accurate, complete, and truthful.
(3) An ACO that seeks to participate in the Shared Savings Program must agree that CMS can share a copy of their application with the Antitrust Agencies.
(b) Condensed application form. For determining eligibility for agreement periods beginning before July 1, 2019:
(1) PGP demonstration sites applying to participate in the Shared Savings Program will have an opportunity to complete a condensed application form.
(2) A Pioneer ACO may use a condensed application form to apply for participation in the Shared Savings Program if it satisfies all of the following criteria:
(i) The applicant is the same legal entity as the Pioneer ACO.
(ii) The applicant's ACO participant list does not contain any ACO participant TINs that did not appear on the “Confirmed Annual TIN/NPI List” (as defined in the Pioneer ACO Model Innovation Agreement with CMS) for the applicant ACO's last full performance year in the Pioneer ACO Model.
(iii) The applicant is not applying to participate in the one-sided model.
(c) Application review. CMS reviews applications in accordance with § 425.206.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.