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These beneficiaries are those who received at least one primary care service during the assignment window or applicable expanded window for assignment (as defined in 425.20) from a physician who is an ACO professional in the ACO and who is a primary care physician as defined under 425.20 or who has one of the primary specialty designations included in 425.402(c), a FQHC or RHC that is part of the ACO, or an ACO professional in the ACO whom the beneficiary designated as responsible for coordinating their overall care under 425.402(c)

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We propose that ACOs with a proportion of assigned beneficiaries who are enrolled in the Medicare Part D LIS or dually eligible for Medicare and Medicaid of less than 20 percent would be ineligible for a HEBA