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.
The Health Law team at von Briesen will be posting additional information on the ACO final rule and its accompanying guidance.