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As mentioned previously, excessive distribution of ( prepaid shared savings could result in several undesirable outcomes, such as ACOs accruing debt to CMS that they are unable to repay, which could disrupt the ACOs' operations and participation in the Shared Savings Program

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However, these commenters also acknowledged that the AMA RUC review process could take years

A reconciliation of the rebate amount may result in an increase, decrease, or no change to the rebate amount, compared to the Rebate Report for an applicable period or a previous reconciliation in the case of reconciliation conducted 36 months after issuance of the Rebate Report (see proposed 428.401(d)(3))

Carcinogenesis 23 , 19792004 (2002)