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American Indian and Alaskan Native Tribes each have a unique history and culture, which can include a different understanding and relationship with tobacco

So reducing the number of cigarettes you smoke a day is a good first step

(c) * * * (3) * * * (iv) For performance year 2025 and subsequent performance years, if the ACO reports the APP Plus quality measure set and meets the data completeness requirement at 414.1340 of this subchapter and receives a MIPS Quality performance category score under 414.1380(b)(1) of this subchapter, CMS will use the higher of the ACO's health equity adjusted quality performance score or the equivalent of the 40th percentile MIPS Quality performance category score across all MIPS Quality performance category scores, excluding entities/providers eligible for facility-based scoring, for the relevant performance year

Additionally, we explained that it could be difficult for the CMS Innovation Center to conduct a viable test of a specialty or disease-specific model, if we were to require that beneficiaries who have previously designated an ACO professional as their primary clinician remain assigned to the Shared Savings Program ACO under all circumstances

Cyber Incident Update 9/26/25 at 09:00 am EST: We continue to work this morning with our cybersecurity team and continue to make progress