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Email On April 8, 2016, the IRS released private letter ruling 201615022 denying tax-exempt section 501(c)(3) status to a nonprofit accountable care organization (“ACO”) that did not participate in the Medicare Shared Savings Program (“MSSP”). This adverse determination raises questions about the ability of an ACO outside of the MSSP to qualify for tax-exempt status under section 501(c)(3). https://www.cadwalader.com/resources/clients-friends-memos/irs-ruling-sounds-alarm-over-tax-exempt-status-of-nonprofit-acos-operating-outside-of-the-medicare-shared-savings-program