Advertisement

May 25, 2013

CMS Releases Final ACO Rule

The Centers for Medicare & Medicaid Services (CMS) today issued its final rule for Accountable Care Organizations (ACOs). In today’s announcement, CMS Administrator Don Berwick noted that more than 1,300 comments were received on the proposed rule. The final rule incorporates a number of these suggestions, including:

  • Increasing incentives and streamlining the Shared Savings Program;
  • Extending the benefits of the new program to a broader range of beneficiaries;
  • Making the one-sided model truly one-sided;
  • Expanding participation to Rural Health clinics, Federally Qualified Health Centers, and organizations where specialists provide primary care; and
  • Providing a flexible starting date in 2012

In conjunction with the release of CMS’ final rule on ACOs, the Office of Inspector General released an interim final regulation on waivers of fraud and abuse provisions; the Internal Revenue Service issued a fact sheet on tax exempt organizations participating in the Shared Savings Program; and the Department of Justice (DOJ) and the Federal Trade Commission (FTC) today issued a final version of a joint policy statement on antitrust enforcement. The FTC and DOJ final policy statement:

  • Preserves an antitrust “safety zone” for certain ACOs;
  • Provides examples of conduct that, under certain circumstances, may raise competitive concerns;
  • Provides expanded coverage – the policy statement no longer applies only to collaborations formed after March 23, 2010; and
  • Shifts antitrust review from mandatory to voluntary review.
©2013 von Briesen & Roper, s.c

About the Author

Meghan O’Connor is a member of the Health Care Practice Group. Her practice focuses on general health law including managed care and provider contracting, risk management, and regulatory compliance.

Prior to joining von Briesen, Meghan worked for the Centers for Medicare and Medicaid Services where she consulted with states regarding federal health law, regulation and policy, evaluating managed care contracts and conducting compliance reviews.

414-287-1586

Boost: AJAX core statistics

Legal Disclaimer

You are responsible for reading, understanding and agreeing to the National Law Review's (NLR’s) and the National Law Forum LLC's  Terms of Use and Privacy Policy before using the National Law Review website. The National Law Review is a free to use, no-log in database of legal and business articles. The content and links on www.NatLawReview.com are intended for general information purposes only. Any legal analysis, legislative updates or other content and links should not be construed as legal or professional advice or a substitute for such advice. No attorney-client or confidential relationship is formed by the transmission of information between you and the National Law Review website or any of the law firms, attorneys or other professionals or organizations who include content on the National Law Review website. If you require legal or professional advice, kindly contact an attorney or other suitable professional advisor.  

Some states have laws and ethical rules regarding solicitation and advertisement practices by attorneys and/or other professionals. NLR does not accept advertising from attorneys or law firms. The National Law Review is not a law firm nor is www.NatLawReview.com  intended to be an advertisement or a referral service for attorneys and/or other professionals. The NLR does not wish, nor does it intend, to solicit the business of anyone or to refer anyone to an attorney or other professional.  NLR does not answer legal questions nor will we refer you to an attorney or other professional if you request such information from us. 

Under certain state laws the following statements may be required on this website and we have included them in order to be in full compliance with these rules. The choice of a lawyer or other professional is an important decision and should not be based solely upon advertisements. Attorney Advertising Notice: Prior results do not guarantee a similar outcome. Statement in compliance with Texas Rules of Professional Conduct. Unless otherwise noted, attorneys are not certified by the Texas Board of Legal Specialization, nor can NLR attest to the accuracy of any notation of Legal Specialization or other Professional Credentials.