Accountable Care Organizations

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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.

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