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We noted that the existing reopening authority at 425.315 and the proposed financial methodology to address improper payments in such a reopening are not intended to address particular instances of low-value improper payments which, in an individual case may be to the benefit of either the ACO ( or CMS and in the aggregate are likely have a de minimis net effect on program expenditures in the long run

doi: 10.1038/s41467-023-41121-z 142 ZhouQHuangGSiJWuYJinSJiYet al

As discussed in earlier rulemaking, we have used the authority under section 1899(i)(3) of the Act to adopt alternative policies to the provisions of section 1899(d)(1)(B) of the Act for updating the historical benchmark [578] and calculating performance year expenditures, [579] among other factors

Is a COA available

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