CMS has sent its long-awaited Medicare Shared Savings Program/Accountable Care Organization (ACO) final rule to the White House Office of Management and Budget (OMB) for final regulatory clearance – the last step before it reaches the Federal Register. The text of the rule is not available at this stage, and the time needed for OMB review can vary from days to months, but the regulation finally is nearing release. Reed Smith will be analyzing the rule when it is issued.