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Fee-for-Service Accountable Care Organizations

K&L Gates LLP

Urinary Catheter Fraud Sparks Proposed Medicare Payment Changes for ACOs

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Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program got good news from The Centers for Medicare and Medicaid Services (CMS) related to widespread fraud involving urinary catheters that...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

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Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

Mintz - Health Care Viewpoints

Transforming Primary Care: CMS Launches Making Care Primary (MCP) Model

The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model—the Making Care Primary (MCP) Model—geared towards smaller, independent primary care practices and organizations that want to participate...more

Foley & Lardner LLP

Antitrust: DOJ Scuttles ACO Guidance, Unsettles Ground under Provider Joint Contracting Models

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On Friday, February 6, 2023, the Department of Justice (DOJ) announced the withdrawal of the 2011 Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings...more

Proskauer - Health Care Law Brief

CMS Responds to Industry Stakeholder Feedback, Redesigns and Renames the GPDC Model for DCEs as the ACO REACH Model

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)...more

King & Spalding

Medicare Announces Geographic-Based Approach to Value-Based Care

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On December 3, 2020, CMS unveiled a new payment and care delivery model, the Geographic Direct Contracting Model (Model). The Model is a geographic-based approach to value-based care aimed at improving the quality of care...more

Sheppard Mullin Richter & Hampton LLP

CMS Announces New Geographic Direct Contracting Model: Letters of Interest Due by December 21, 2020

On December 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced key details concerning a new value-based reimbursement and patient care model – the Geographic Direct Contracting Model (the “Model” or “Geo”)....more

Robinson+Cole Health Law Diagnosis

CMS Updates and Revises COVID-19 FAQs on Medicare FFS Billing

On April 9 and 10, 2020, the Centers for Medicare and Medicaid Services (CMS) updated and revised their COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing....more

King & Spalding

CMS Releases Request for Application for New Direct Contracting Models

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On November 25, 2019, CMS released a Request for Application (RFA) describing how organizations can apply to participate in two of three Direct Contracting Model options. The Direct Contracting Model is a set of voluntary...more

Alston & Bird

The Primary Cares Initiative: What to Know and How to Prepare

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Our Health Care Group navigates the latest federal pathways to transform the nation’s health care system to value-based care....more

Epstein Becker & Green

CMS’s Direct Contracting Model: What’s New from Next Gen?

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The Centers for Medicare & Medicaid Services (“CMS”) recently introduced three new population-based payment (“PBP”) risk-sharing Direct Contracting (“DC”) model options that intend to decrease expenditures and increase...more

Dorsey & Whitney LLP

CMS’s New “Primary Cares Initiative” Places Primary Care at the Center of the Shift to Value-Based Care

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On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two sweeping new payment innovation models under the Primary Cares Initiatives. The models will seek to incentivize primary care and other...more

Manatt, Phelps & Phillips, LLP

CMS Final Rule Redesigns the Medicare Shared Savings Program

On December 21, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule redesigning the Medicare Shared Savings Program (the Program) for Accountable Care Organizations (ACOs). The policies reflected in...more

Bradley Arant Boult Cummings LLP

CMS Finalizes Redesign of Medicare Shared Savings Program - Healthcare Alert

On December 31, 2018, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that redesigns the Medicare Shared Savings Program (MSSP). The rule implementing this redesign, titled “Pathways to Success,”...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

King & Spalding

CMS Announces Proposed Rule to Revise the Medicare Shared Savings Program

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On August 9, 2018, CMS issued a proposed rule for restructuring the Medicare Shared Savings Program (Shared Savings Program) which would, among other things, change the participation options available under the program for...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Smith Anderson

CMS makes economics of primary care ACOs more appealing

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As you may have read, accountable care organizations have met uneven success over the last several years. But, when they are broken down into categories, physician-sponsored ACOs have done better, particularly those with a...more

Polsinelli

Making Sense of the MACRA Final Rule, Part 1 of 3: Essential Concepts

Polsinelli on

On Oct. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The nearly 2,400 pages of...more

McDermott Will & Emery

Digital Health: An Improving Environment for Investors

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The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more

Smith Anderson

ACO Insider: MACRA – Don’t Let Indecision Be Your Biggest Decision

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By now, most of us have heard of accountable care organizations and bundled payment. But for many of you, the shift to value-based population health management or compensation based on performance hasn’t affected your...more

Foley & Lardner LLP

CMS Proposes Additional Changes to MSSP Regulations

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The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule modifying the Medicare Shared Savings Program (MSSP) regulations (the “Rule”). Among other changes, the Rule proposes (a) to modify the...more

Foley & Lardner LLP

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

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Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

Fenwick & West Life Sciences Group

Key Digital Health Investment Trends to Watch

Our fourth annual Digital Health Summit brought together a select group of investors active in the digital health, life sciences, medical device, and healthcare industries for a one-day meeting to discuss the future of...more

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