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To address these issues, we are proposing technical changes to the regulation text at 425.605(a)(1)(ii)(C), 425.610(a)(2)(ii)(C), and 425.655(d)(2) to align the language describing the calculation of the weights that will be used to compute aggregate risk score growth across the three provisions and to clarify that the weight applied to the growth in ACO and regional risk scores for each Medicare enrollment type, respectively, would be equal to the product of the ACO's historical benchmark expenditures, adjusted in accordance with 425.652(a)(8), for that enrollment type and the ACO's performance year assigned beneficiary person years for that enrollment type

As required under section 1860D-14B(b)(1)(C)(ii) of the Act, CMS will reduce the total rebate amount calculated under 428.201(a), if any is owed, for a generic Part D rebatable drug or biosimilar when CMS determines there is a severe supply chain disruption, as defined in 428.300, during the applicable period such as that caused by a natural disaster or other unique or unexpected event

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