Shared Savings Program Application

Posting of the Notice of Intent to Apply and the Application 

UPDATE: See the 2014 Notice of Intent (NOI) Memo for details on how to fill out the form.  We will post the 2014 Application in June. 

National Provider Calls for the 2014 Application Period

We will host several calls leading up to the application submission due date.  Please monitor our CMS Teleconferences and Events page for details.

Steps to the Shared Savings Program Application Process

Step 1:  Submit a Notice of Intent to Apply - DUE May 31, 2013

Step 2:  Get a CMS User ID to Submit Your Application Online - Form CMS-20037 - Complete after you submit an NOI, DUE June 10, 2013

Step 3:  Complete Your Application - Program Year 2014 coming soon

Who to Contact for Assistance

Application Cycle: Key Dates for Program Year 2014

*  Date an organization must receive a favorable reconsideration review determination in order to qualify for the start date indicated on the application.

Step 1: Submit a Notice of Intent to Apply - May 1 through 31, 2013 for Program Year 2014

Each ACO must submit a short Notice of Intent to Apply (NOI) through the Web form. We must get your completed NOI no later than 5 p.m. EST May 31, 2013.

Step 2: Get a CMS User ID to Submit Your Application - (Complete after you submit an NOI, DUE June 10, 2013)

To submit your application, you need a CMS User ID to access the Health Plan Management System (HPMS.)  

Submit Form CMS-20037 Application for Access to CMS Computer Systems by

• using the link and instructions provided in your NOI acknowledgement Email,
• via tracked mail (Federal Express, United Parcel Service, etc.) and; 
• no later than June 6, 2013.  Do not wait until the deadline.

Step 3: Complete Your Application

You must submit your application online through HPMS.  The information posted below is for reference only.

We will accept applications from July 1 through July 31, 2013.

Application (2013 Toolkit is available for reference.  The 2014 Toolkit is coming soon)

• Use the Toolkit to complete your Application (updated: 7/25/2012) [PDF, 260KB].

Forms (2013 Forms are available for reference.  The 2014 Forms are coming soon)

• Form CMS-588  Electronic Funds Transfer (EFT) Authorization Agreement See here for FAQs.
  Formerly “Appendix A”

Templates (2013 Templates are available for reference.  The 2014 Templates are coming soon)

• ACO Participant List Template (updated 7/30/12) [ZIP, 4KB] . See here for FAQs.
• Governing Body Template [ZIP, 10KB] . See here for FAQs.
• ACO Participation Agreement Template [ZIP, 282KB] .
• Executed Agreement Template [ZIP, 11KB] .

Who to Contact for Assistance

• For NOI or application questions:   SSPACO_Applications@cms.hhs.gov or (410) 786-8084
• For help with Form CMS-20037 or CMS User ID:  HPMS_Access@cms.hhs.gov or (800) 220-2028
• For password resets or if your account is locked:  CMS_IT_SERVICE_DESK@cms.hhs.gov or (800) 562-1963
• For problems using HPMS and technical assistance:  HPMS@cms.hhs.gov or (800) 220-2028

Visit this page frequently for updated information and materials.