Medicare Shared Savings Program

News & Analysis as of

Medicare Shared Savings Program Applications for January 1, 2016 Start Date

CMS is proceeding with the application process for the Medicare Shared Savings Program for the January 1, 2016 program start date. Applicants interested in participating must submit a Notice of Intent to Apply by May 29,...more

CMS Touts Pioneer ACO Model Savings and Potential Expansion

On May 4, 2015, CMS announced that the Pioneer Accountable Care Organization (ACO) Model generated $384 million in savings to Medicare over two years. Under the Pioneer ACO Model, which was authorized by the ACA, health care...more

Also In The News - Health Headlines - May 2015 #2

CMS Publishes Corrected Comment Deadline for FY 2016 IPPS and LTCH Proposed Rule; Comments Due by June 16, 2015 – On May 5, 2015, CMS published in the Federal Register a corrected comment period for the FY 2016 Medicare IPPS...more

CMS Announces Next Generation ACO with Increased Risk and Reward

On March 10, 2015, the Centers for Medicare & Medicaid Services announced its “Next Generation ACO Model,” which CMS hopes will provide more experienced accountable care organizations an opportunity to assume higher levels of...more

CMS Announces the Next Generation of Accountable Care Organizations Aimed at Increased Risk Sharing and Program Sustainability

The Centers for Medicare and Medicaid Services (“CMS”) announced on March 10th a new model for Accountable Care Organizations (“ACOs”) that will evaluate the capacity of ACOs to assume “near-complete financial risk” while...more

Important Recommendations from the MedPAC March Report to Congress, Part Two

Tuesday’s post discussed the recommendations of the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) with regard to fee-for-service (“FFS”) payment systems. ...more

Accountable Care Organization Update

In This Issue: - Summary of Next Generation ACO Model - Summary of Additional Guidance on ACO Pre-Participation & Participation Waivers - For More Information - Excerpt from Summary of Next...more

The Next Generation ACO Model

On March 10, 2015, the Centers for Medicare and Medicaid Services (CMS) introduced its latest accountable care initiative, the Next Generation ACO Model. Building upon experience from the Pioneer ACO Model and the Medicare...more

CMS Announces Next Generation ACO Model

CMS announced a new ACO payment initiative on March 10, 2015, the Next Generation ACO Model, designed for entities experienced in coordinating care for populations of patients. The announcement reflects CMS’ commitment to...more

CMS Unveils New ACO Model

On March 10, 2015, CMS announced a new accountable care organization (ACO) model designed to increase both risk-sharing by participating providers and potential shared savings. Parties interested in participating in this...more

New Postings on the Reed Smith Health Industry Washington Watch Blog

The Reed Smith Health Industry Washington Watch blog has been updated to report on recent health policy developments, including the following...more

Next Generation ACOs: CMMI Doubles Down on the Two-Sided Risk ACO Model

While one part of the Affordable Care Act, exchange subsidies, hangs in the balance with the Supreme Court’s upcoming decision in King v Burwell, CMS is moving forward aggressively with the evolution of a less controversial...more

CMS Posts Deadlines for 2016 Medicare Shared Savings Program Application Cycle; Schedules Informational Calls

CMS is gearing up for the program year 2016 Medicare Shared Savings Program, under which physicians, hospitals, and certain other types of providers and suppliers may form Accountable Care Organizations (ACOs) to provide...more

Medicare ACO v.3.0—More Risk, More Money?

The Centers for Medicare and Medicaid (CMS) announced on March 10, 2015 that it is adding a new Accountable Care Organization (ACO) model to its cadre of innovative models. Titled the “Next Generation ACO Model,” CMS’ new ACO...more

Obama Administration Announces “Next Generation ACOs”

In a highly anticipated announcement on Tuesday, March 10, the Centers for Medicare and Medicaid Services (CMS) released details for a new Accountable Care Organization (ACO) program called the Next Generation ACO (NGACO). ...more

HHS Announces Next Generation ACO Model of Payment

On Tuesday, March 10, 2015, the U.S. Department of Health and Human Services ("HHS") announced the introduction of the Next Generation Accountable Care Organization ("ACO") Model of payment and care delivery. ACOs...more

CMS Call on Physician Quality Reporting Programs (March 18)

On March 18, 2015, CMS is hosting a call to discuss how providers may report once across various 2015 Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), the Medicare Electronic...more

Will the ACO Proposed Rule Save the Shared Savings Program?

In 2011, CMS implemented the Accountable Care Organization (“ACO”) Shared Savings Program, which aims to promote increased savings for the Medicare program, improve health care quality, and create a more efficient and...more

Healthcare Legal News: Volume 5, Number 1

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014....more

Summary Chart Of Proposed Amendments To 42 C.F.R. Part 425 Governing The Medicare Shared Savings Program

Mintz Levin has prepared a chart of the proposed amendments to 42 C.F.R. Part 425 governing the Medicare Shared Savings Program. This chart provides a summary of each proposed amendment and its potential impact....more

IRS Interim Guidance Creates New Category of Permissible Arrangements - Public Comments Due January 22, 2015

On October 24, 2014, the IRS issued Announcement 2014-67, which “amplifies” Rev. Proc. 97-13 regarding certain management contracts that do not result in private business use. Prior to this Announcement, Rev. Proc. 97-13...more

IRS Interim Guidance Creates New Category of Permissible Arrangements

On October 24, 2014, the IRS issued Announcement 2014-67, which “amplifies” Rev. Proc. 97-13 regarding certain management contracts that do not result in private business use. Prior to this Announcement, Rev. Proc. 97-13...more

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

CMS Proposes Changes to the Medicare Shared Savings Program MSSP

On December 1, 2014, CMS published its proposed changes and updates to the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs). Comments are due by February 6, 2015. Below is a summary of the...more

CMS’ Proposed Regulations Include Significant Antitrust Implications For Entities Interested In Forming ACOs

The Centers for Medicare & Medicaid Services (CMS) released proposed regulations to clarify and build on current regulatory requirements for Accountable Care Organizations (ACOs) that participate in the Medicare Shared...more

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