CMS Releases Medicare Shared Savings Application

November 15, 2011
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After the anncounement of the final rule on 10/20, the Center for Medicare & Medicaid (CMS) has released the 2012 application for their Medicare Shared Savi

After the anncounement of the final rule on 10/20, the Center for Medicare & Medicaid (CMS) has released the 2012 application for their Medicare Shared Savings program. Accountable Care Organizations (ACO) that are interested have the option of two start dates of April 1, 2012 and July 1, 2012.
The following is the outline steps to the Medicare Shared Savings Program Application Process
Step 1: Submitting the NOI is the first step in our application process.
If you are interested in applying for participation in the Medicare Shared Savings Program, please follow the instructions in the Notice of Intent to Apply (NOI) Memo in the Downloads section of this page.
Step 2: Submitting the application and the accompanying required documents is the second step in our application process.
Now available 11/10/11: The Medicare Shared Savings Program Application and accompanying appendices
After submitting an NOI, please follow the instructions in the Medicare Shared Savings Program Application 2012 document to submit your application. An application can be submitted via tracked mail or electronically through the Health Plan Management System (HPMS). The complete application package includes the following documents available in the Downloads section of this page:
Medicare Shared Savings Program Application 2012
Appendix A-Electronic Funds Transfer (EFT) Authorization Agreement (CMS Form 588)
Appendix B-Participant List
Appendix C-Data Use Agreement (DUA)
Appendix D-Application Reference Guide
Refer to the Appendix D-Application Reference Guide document in the Downloads section of this page for further details on how to complete the application.
CMS will be posting a PDF version of the application with fields that can be filled electronically and printed for those who are submitting paper applications.
Application Cycle: Key Dates:
Start Date April 1, 2012 July 1, 2012
2012 applications posted on CMS Web site Fall 2011 Fall 2011
NOIs accepted Nov 1, 2011 – Jan 6, 2012 Nov 1, 2011 – Feb 17, 2012
CMS User ID forms accepted Nov 9, 2011 – Jan 12, 2012 Nov 9, 2011 – Feb 23, 2012
2012 applications accepted Dec 1, 2011 – Jan 20, 2012 Mar 1-30, 2012
2012 application approval or denial decision March 16, 2012 May 31, 2012
Reconsideration review deadline* March 23, 2012 June 15, 2012
* – Date an organization must receive a favorable reconsideration review determination in order to qualify for the start date indicated on the application.
Downloads
ACO NOI Memo-Application [PDF, 199KB]Medicare Shared Savings Program Application 2012 [PDF, 228KB]
Appendix A-Electronic Funds Transfer (EFT) Authorization Agreement (CMS Form 588) [PDF, 104KB]
Appendix B-Participant List [ZIP, 13KB]
Appendix C-Data Use Agreement (DUA) [PDF, 2.06MB]
Appendix D-Application Reference Guide [PDF, 143KB]
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