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If an ACO or CMS terminates the ACOs participation agreement during the agreement period in which it received prepaid shared savings, the ACO must repay all outstanding prepaid shared savings it received in full upon request from CMS ( 425.640(g)(4)), unless the ACO terminates its current participation agreement under 425.220 and immediately enters a new agreement period to continue its participation in the program, in which case CMS may recover the amount owed by recouping from any future shared savings the ACO may be eligible to receive in subsequent agreement periods ( 425.640(g)(4)(ii))