The federal government today issued a series of proposed regulations and guidance documents related to Accountable Care Organizations (ACOs) created by PPACA. ACOs are a key component in the new shared savings program, which will directly link payment with quality and cost savings. PPACA established broad outlines of ACO requirements and shared savings program. Today's proposed regulations issued by the Centers for Medicare and Medicaid Services (CMS) provide much more detail on what is required to qualify as an ACO and to participate in shared savings programs. The notice is currently "on display" and is expected to be published in next week's federal register. CMS will accept formal comments on the proposed rule during a 60 day comment period.
The CMS and the Office of Inspector General of the Department of Health and Human Services (OIG) also issued a notice with comment period to provide for a waiver of certain fraud and abuse laws, including the anti-kickback law, the Stark law, and civil money penalty provisions for appropriately structured ACOs participating in the shared savings program. CMS/OIG specifically seek comments on several elements of the waiver process over a 60 day comment period.
Finally, the Department of Justice (DOJ) and the Federal trade Commission (FTC) issued a joint notice with comment period proposing an enforcement policy regarding the application of antitrust laws to ACOs under the shared savings program.
To view the CMS ACO proposed rule, visit: http://www.gpo.gov/fdsys/pkg/FR-2011-04-07/pdf/2011-7880.pdf
To view the CMS/OIG waiver notice with comment period, visit: http://www.gpo.gov/fdsys/pkg/FR-2011-04-07/pdf/2011-7884.pdf
To view the DOJ/FTC statement, visit:http://www.ftc.gov/os/fedreg/2011/03/110331acofrn.pdf