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Monitoring ACO Eligibility for and Use of Prepaid Shared Savings To provide CMS with a clear indication of how ACOs intend to spend prepaid shared savings, help provide adequate protection to the Medicare Trust Funds, and prevent funds from being misdirected or appropriated for activities that do not fall within the parameters set forth within proposed 425.640(e), we propose in 425.316(f)(1) to monitor ACOs receiving prepaid shared savings for compliance with 425.640(e) and to determine whether it would be appropriate to withhold or terminate an ACO's prepaid shared savings under 425.640(h)(1) and (h)(2)