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Please see the next section in this unit on Medicare Advantage PPO Network Sharing. A Medicare Advantage Private-Fee-For-Service (PFFS) plan is one in which the member may go to any Medicare-approved doctor or hospital that accepts the plans terms and conditions of participation

As we have explained in prior rulemaking, the MSR/MLR protects against an ACO earning shared savings or being liable for shared losses when the change in expenditures represents normal, or random, variation rather than actual program performance (83 FR 67923 through 67926)

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This waiver would ease the administrative burden, as ASM participants would be required to only report ASM performance category measures

In the phase 3 ACHIEVE-1 trial, published in June 2025, the oral small-molecule GLP-1 receptor agonist orforglipron significantly reduced the glycated hemoglobin level over a period of 40 weeks in adults with early type 2 diabetes

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