Accountable Care Organizations

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This presentation covers the implications for ACOs under physician self-referral, anti-kickback, civil monetary penalty and antitrust laws.

Medicare Accountable Care Organizations: Section 3022 of Affordable Care Act Basic Requirements for ACO Participation; Formal legal structure to receive and distribute shared savings; Minimum of 5,000 assigned beneficiaries; Sufficient number of primary care professionals and sufficient information on professionals for beneficiary assignment and payments; Participation in program for at least three years; Leadership and management structure (including clinical and administrative systems);and Processes to promote evidence based medicine

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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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