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Responsible use, moderation, and awareness are key to minimizing harm

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CMS also proposes to limit participation in the prepaid shared savings payment option to ACOs that have fully repaid all shared losses they may owe and any advance investment payments they may have received in a prior agreement period, and to ACOs that participate in a two-sided risk track (Levels C-E of the BASIC track or the ENHANCED track), as these tracks require a repayment mechanism in accordance with 425.204(f), which could be used to recoup prepaid shared savings

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For example, psychoactive substance dependence is often coded under F19.20 when alcohol is used alongside other drugs