CMS has just put on display an interim final rule with comment period to establish special policies to assess the performance year 2017 financial and quality performance of Medicare Shared Savings Program accountable care organizations (ACOs) affected by extreme and uncontrollable circumstances, such as Hurricanes Harvey, Irma, and Maria and the California wildfires. CMS is aligning the Shared Savings Program policy with the extreme and uncontrollable circumstances rules it recently promulgated for the Quality Payment Program. CMS will use the determination of an extreme and uncontrollable circumstance under the Quality Payment Program, including the identification of affected geographic areas and applicable time periods, to trigger the extreme and uncontrollable circumstances policies under the Shared Savings Program. The rule establishes special criteria for determining ACO quality performance scores and modifies the payment methodology under Tracks 2 and 3 to mitigate shared losses owed by ACOs affected by extreme and uncontrollable circumstances during performance year 2017. CMS expects the total increase in shared savings payments and total reduction in shared loss payments for ACOs impacted by this rule in 2017 to be approximately $3.5 million. The regulation is effective January 20, 2018. CMS will accept comments on the rule until February 20, 2018.