Accountable Care Organizations

Background Documents

In October 2011, the Centers for Medicare & Medicaid Services (CMS) issued a final rule establishing a shared savings program for accountable care organizations (ACOs).

Simultaneously, the Antitrust Division and the Federal Trade Commission issued a joint Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program. In developing the final policy statement, the agencies considered the public comments submitted in response to the March 2011 proposed statement.

Find more information on the program and on the development of the CMS rule at the CMS website and the Health and Human Services website.

Send questions about primary service area share calculations, or the policy statement in general, by e-mail to

Procedure for Voluntary Expedited Review

Before its entrance into the shared savings program, a newly formed ACO seeking a voluntary expedited antitrust review should submit its request in writing, along with a completed cover sheet, to both agencies, either by mail or electronically. If submitting by mail, send your request and cover sheet to the following addresses:

Office of the Assistant Attorney General, Antitrust Division
Department of Justice
Main Justice Building, Room 3109
950 Pennsylvania Avenue NW
Washington, DC 20530
(for non-U.S. Postal Service deliveries, use ZIP code 20004)

Federal Trade Commission
Bureau of Competition
Premerger Notification Office, Room 303
600 Pennsylvania Avenue NW
Washington, DC 20580

If submitting electronically, send your request and cover sheet to both agencies at the following e-mail addresses:

Because mail delivered to the agencies by the U.S. Postal Service is subject to delay due to heightened security screening, please consider submitting your request and cover sheet electronically. If sending hard copies, the agencies ask that you send them by courier or overnight service, if possible.

The agencies will notify you which agency will review your request and where you must provide the documents and information outlined in Section IV.B.2 of the policy statement.

Updated March 21, 2022

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