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CMS would also continue to review the eligibility criteria over time and may expand eligibility in future years if we determine that doing so is in the interests of the Shared Savings Program, participating ACOs, and their beneficiaries, and all requirements under section 1899(i)(3) of the Act are satisfied

This includes both intentional discrimination and any unconscious bias that may result in discrimination against a protected group

In the CY 2024 PFS final rule, we established the Medicare Clinical Quality Measures for Accountable Care Organizations Participating in the Medicare Shared Savings Program (Medicare CQMs) as a new collection type for Shared Savings Program ACOs reporting on the Medicare CQMs within the APP quality measure set for performance year 2024 and subsequent performance years (88 FR 79107)

There are only so many cops who are going to catch them. When these same players arrive at the big leagues, no prohibition is in place and there is unlikely to be one anytime soon