(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.
[76 FR 67973, Nov. 2, 2011, as amended at 80 FR 32834, June 9, 2015]