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Additionally, while unspent funds received for a performance year must be reallocated in the spend plan for the ACO's next performance year as noted in 425.640(e)(3), if an ACO fails to spend a majority of the prepaid shared savings they receive in a performance year, CMS may withhold future quarterly payments until the ACO spends the funding they have already received and reports this spending to CMS through an updated spend plan

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Retrieved May 1, 2017