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We are finalizing as proposed the Complex Organization Adjustment beginning in the CY 2025 performance period/2027 MIPS payment year to account for the organizational complexities faced by Virtual Groups and APM Entities, including Shared Savings Program ACOs, when reporting eCQMs as described in section IV.A.4.f.(1)(b)(iii) of this final rule in recognition of commenters' concerns regarding increased burden and to incentivize ACOs to report eCQMs and support their transition to digital quality measurement

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