---
kind: "section"
citation: "42 C.F.R. § 425.306"
title: "42"
number: "425.306"
heading: "Participant agreement and exclusivity of ACO participants."
url: "https://uscodex.org/cfr/42/425.306"
---

# §425.306. Participant agreement and exclusivity of ACO participants.

- (a) Each ACO participant must commit to the term of the participation agreement and sign an ACO participant agreement that complies with the requirements of this part.
- (b)
  - (1) Except as specified in [paragraph (b)(2)](#b-2) of this section, ACO participants are not required to be exclusive to one Shared Savings Program ACO.
  - (2) Each ACO participant that submits claims for services used to determine the ACO's assigned population under [subpart E](/cfr/42/subpartE.md) of this part must be exclusive to one Shared Savings Program ACO. If, during a benchmark or performance year (including the 3-month claims runout for such benchmark or performance year), an ACO participant that participates in more than one ACO submits claims for services used in assignment under [subpart E](/cfr/42/subpartE.md) of this part, then:
    - (i) CMS will not consider any services billed through the TIN of the ACO participant when performing assignment under subpart E of this part for the benchmark or performance year.
    - (ii) The ACO may be subject to the pre-termination actions set forth in [§ 425.216](/cfr/42/425.216.md), termination under [§ 425.218](/cfr/42/425.218.md), or both.

## Notes

### Amendments

[80 FR 32840, June 9, 2015, as amended at 82 FR 53369, Nov. 15, 2017]

### Authority

Authority: 42 U.S.C. 1302, 1306, 1395hh, and 1395jjj.

### Source

Source: 76 FR 67973, Nov. 2, 2011, unless otherwise noted.

### Amendments

[80 FR 32840, June 9, 2015, as amended at 82 FR 53369, Nov. 15, 2017]