Medicare Shared Savings Program

News & Analysis as of

Touching Up that Old Two Step: CMS Proposes Revisions to its Beneficiary Assignment Methodology

On Dec. 1, 2014, the Centers for Medicare and Medicaid Services (“CMS”) released a new proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). This advisory focuses...more

CMS Proposes Financial Revisions to MSSP to Encourage Continued and Expanded Participation

Many critics have suggested that the November 11, 2011 final rule establishing the MSSP created a financial model that over time would not be sustainable. ACOs viewed the requirement to take risk after the initial three years...more

CMS ACO Proposed Rule to Extend One-Sided Risk Track While Incentivizing Performance-Based Risk

On December 1, 2014, the U.S. Centers for Medicare & Medicaid Services (CMS) released a 429-page Proposed Rule setting forth significant changes that will affect the evolution of the Medicare Shared Savings Program (MSSP) and...more

CMS Proposes Changes to the Medicare Shared Savings Program

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...more

Health Reform + Related Health Policy News - December 2014, Issue 1

In This Issue: - Top News ..Congress Passes Omnibus Spending Package ..HRSA Cancels Plan for 340B ‘Mega Reg’; Congress Weighs Options ..Supreme Court to Hear Challenge to ACA...more

Beneficiary Assignment in the Proposed Revised Medicare Shared Savings Program Regulations

This post addresses the changes that the rule would make to how CMS assigns beneficiaries to an ACO participating in the MSSP. The Proposed Rule places a renewed emphasis on primary care for beneficiary assignment. Section...more

CMS Proposes Sharing More Data With ACOs Participating in the Medicare Shared Savings Program

CMS may be ready to ramp up the data it is willing to share with Accountable Care Organizations (“ACOs”) that participate in the Medicare Shared Savings Program (“MSSP”). CMS explained in the November 2011 final rule...more

Changing Basic Rules of the Game: CMS Proposed Rule Relating to ACO Governance and Contracting

The Centers for Medicare and Medicaid Services released a new proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). This advisory expands upon our initial...more

MSSP Proposed Rule Seeks to Enhance ACO Transparency and Patient Engagement

Under the Medicare Shared Savings Program (“MSSP”) ACO proposed rule, CMS has proposed additional program requirements, beneficiary protections and participation agreement procedures to enhance ACO transparency and improve...more

CMS Releases New Proposal to Improve Accountable Care Organizations

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule aimed at revitalizing accountable care organizations (ACOs) under the Medicare Shared Savings Program (MSSP). Given the low level of ACOs...more

Keeping Track of the Tracks: Proposed ACO Regulations Alter MSSP Financial Models

Last week, the Centers for Medicare and Medicaid Services (“CMS”) released a new proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). This advisory focuses on...more

CMS Invites Comment on Availability of Waivers for ACOs That Particularly Affect Post-Acute Care

Solutions and opportunities may be on the horizon for post-acute providers (“PAPs”) and hospitals participating (or thinking of participating) in ACOs that have reservations about taking on additional downside cost risk...more

CMS’s Proposed Changes to the MSSP Aim to Grow Two-Sided Risk Models and Modify Processes for Evaluating and Facilitating Care...

The Centers for Medicare & Medicaid Services (CMS) has published long-awaited changes to the Medicare Shared Savings Program (MSSP). The official version of the proposed rule (the Proposed Rule), released December 8th, 2014,...more

Health Care Reform Implementation Update

We are now more than two weeks into the Affordable Care Act (ACA’s) second open enrollment period, and 765,000 individuals have obtained coverage through HealthCare.gov. On Capitol Hill, House lawmakers filed a lawsuit...more

Medicare Shared Savings Program: CMS Announces Proposed Changes Affecting All ACOs

On December 1, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule that would implement changes to the Medicare Shared Savings Program (“MSSP”). We summarized the original rules, finalized on...more

CMS MSSP Proposed Rule Provides Clarity, Additional Risk Track, and Potential Relief From ACO Exclusivity for Certain Specialists

On December 1, 2014 the Centers for Medicare and Medicaid Services (CMS) issued a Proposed Rule that would implement several changes to the Medicare Shared Savings Program (MSSP). The most significant proposed changes relate...more

CMS Proposes Rules to Improve Accountable Care Organizations (ACOs)

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule intended to make ACOs and Medicare Shared Savings Plans more practical and attractive to potential providers. The proposed rule was released on...more

CMS Issues Proposed Rule Addressing Changes to Medicare Shared Savings Program

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule (the “Proposed Rule”) on December 1, 2014 regarding certain changes to the Medicare Shared Savings Program (the “Program”). The Proposed Rule,...more

Medicare Shared Savings Program Proposed Rule: Enough Incentive to Encourage More ACO Risk?

On December 1, 2014, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) setting forth long-anticipated changes to the Medicare Shared Savings Program (“MSSP”), including payments...more

CMS Releases Proposed Revised Medicare Shared Savings Program Regulations

The Centers for Medicare and Medicaid Services released, on December 1, 2014, a proposed rule to revise the Medicare Shared Savings Program (“MSSP”) Accountable Care Organization (“ACO”) Regulations. The proposed rule is...more

CMS Releases Proposed New Rule for Accountable Care Organizations

On Dec. 1st, the Centers for Medicare and Medicaid Services released a new proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). The voluminous proposal covers a...more

CMS Releases New Proposed Medicare Shared Savings Program Regulations

The Centers for Medicare and Medicaid Services (“CMS”) released proposed regulations for the Medicare Shared Savings Program (“MSSP”) on Monday December 1, 2014. The proposed regulations are scheduled to be published in the...more

Proposed Regulations in New York for ACO Certification Reflect Medicare Shared Savings Program Influence

The New York State Department of Health (“NYSDOH”) published proposed regulations (the “Proposed Regulations”) in October that establish standards for the issuance of certificates of authority to Accountable Care...more

Internal Revenue Service Releases Interim Guidance Regarding Accountable Care Organizations' Use Of Tax-Exempt Bond-Financed...

On October 24, 2014, the Internal Revenue Service (IRS) released Notice 2014-67, which provides guidance for determining whether a state or local governmental entity or an organization described by Section 501(c)(3) of the...more

ACO Participation By Tax-Exempt Healthcare Organizations – Is Tax-Exempt Financing at Stake?

Does A Tax-Exempt Healthcare Organization’s Participation in an Accountable Care Organization (ACO) Adversely Affect Its Tax-Exempt Financing? IRS Notice 2014-67 Provides Guidance....more

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