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CMS also proposes to limit participation in the prepaid shared savings payment option to ACOs that have fully repaid all shared losses they may owe and any advance investment payments they may have received in a prior agreement period, and to ACOs that participate in a two-sided risk track (Levels C-E of the BASIC track or the ENHANCED track), as these tracks require a repayment mechanism in accordance with 425.204(f), which could be used to recoup prepaid shared savings

(5) If the ACO received prepaid shared savings in the current agreement period or a prior agreement period, the ACO must have fully repaid the amount of prepaid shared savings received through the most recent performance year for which CMS has completed financial reconciliation

For example, psychoactive substance dependence is often coded under F19.20 when alcohol is used alongside other drugs

Please refer to section IV.A.4.c.(1)

As an example, some insurers may consider an applicant on nicotine replacement therapy for non-tobacco rates