CMS Proposes Changes to the Medicare Shared Savings Program

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The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule (Proposed Rule) that would revise regulations governing accountable care organizations (ACOs) that participate in the Medicare Shared Savings Program (MSSP). The Proposed Rule seeks to codify current CMS operational practice and guidance, and makes technical and substantive changes to the MSSP regulations intended to, among other things, encourage increased participation in two-sided risk models offered under the MSSP, modify the beneficiary assignment process, and simplify the data-sharing opt-out process. CMS is seeking public comment on the Proposed Rule, due by February 6, 2015. The full text of the Proposed Rule is available here. Below are highlights of the Proposed Rule.

1. SECOND TRACK 1 AGREEMENT PERIOD -

Currently, the MSSP offers two shared savings payment tracks in which ACOs may participate. Under the one-sided model, known as “Track 1,” an ACO is eligible to receive shared savings payments but is not at risk for any losses. Under the two-sided model, known as “Track 2,” an ACO is eligible to receive a greater share of shared savings payments than under Track 1, but the ACO is also liable to CMS for a portion of its losses if its expenditures are above its benchmark.

Please see full publication below for more information.

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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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