Accountable Care Organizations


In this presentation: Basic Premise for ACOs; Dr. Berwick – CMS Administrator; ACO Vision; Medicare Shared Savings Program and Medicare Accountable Care Organizations: Section 3022 of Affordable Care Act; Organizations that may Become Medicare ACOs; CMS Regulations; Basic Statutory Requirements for ACO Participation; Qualification for Shared Savings; Assignment of Medicare Beneficiaries to ACO; ACO Legal Issues; Civil Monetary Penalty Law (“CMPL”); Anti-Kickback Statute (“AKS”); Physician Self Referral Law/Stark; ACO Problem Under CMPL, AKS and Stark; Existing Regulatory Guidance; Favorable Factors Common to OIG Advisory Opinions and Proposed Stark Exception; CMS October 5 Workshop on Accountable Care Organizations; Panelists for CMP/AKS/Stark; OIG/CMS Overview; OIG/CMS Questions to Panel; Antitrust; Price Fixing; Pro-Competitive Efficiencies; Price Fixing; Mergers; Group Boycotts; FTC Panel; Proposed Safe Harbor Under Consideration; ACO Scale; FTC Questions to Panel; How Will Specialists Participate in ACOs?; and Open Questions.

Please see full presentation below for more information.

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Published In: Antitrust & Trade Regulation Updates, Business Organization Updates, Health Updates, Insurance Updates, Mergers & Acquisitions Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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