News & Analysis as of

Medicare Shared Savings Program

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - July 2024 #1

News Briefs - Texas Federal Court Ruling Puts Noncompete Ban on Hold - A Texas federal court issued a preliminary injunction against the Federal Trade Commission's noncompete ban, which if implemented would allow existing...more

Greenbaum, Rowe, Smith & Davis LLP

HHS Finalizes Rule Establishing Significant Financial Penalties for Information Blocking by Healthcare Providers

On June 24, 2024, the U.S. Department of Health and Human Services (HHS) released a final rule establishing stringent financial penalties, referred to as “disincentives,” for healthcare providers found to have committed...more

Greenbaum, Rowe, Smith & Davis LLP

COVID-19 And Medicare Alternate Payment Programs

Insurance payments for healthcare services and supplies are frequently based on projections of future costs, often measured against a baseline calculated on past costs. However, COVID-19 and its attendant changes to the...more

Baker Donelson

Limited Modifications in Final ACO Fraud and Abuse Waivers Most Notably Include Cut of Gainsharing CMP Waiver

Baker Donelson on

Nearly four years after publishing their joint interim final rule with comment period, effective November 2, 2011 (IFC), the OIG and CMS (Agencies) have finalized the waivers of various fraud and abuse laws in the context of...more

Saul Ewing Arnstein & Lehr LLP

CMS and OIG Issue Final ACO Waivers

On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more

Arnall Golden Gregory LLP

New ACO Data Show Improved Care, Increased Savings in 2014

Medicare Accountable Care Organizations ("ACOs") improved the quality of care they provided and generated financial savings in 2014, according to data recently released by the Centers for Medicare & Medicaid Services ("CMS")....more

Manatt, Phelps & Phillips, LLP

Health Update

Assessing the Medicare Shared Savings Program: Diverse Participants, Diverse Results - Rising healthcare costs and declining reimbursements have placed immense pressure on providers and health systems to manage the...more

Smith Anderson

A Checklist for Entering Shared Savings Contracts: Practical Considerations

Smith Anderson on

It’s no secret that payment for health care services is moving away from a fee-for-service world that rewards volume towards new value-based models that encourage higher quality and more efficient care. Perhaps no value-based...more

Foley & Lardner LLP

Win, Lose, and Push: CMS Announces First Year Results on the Pioneer ACO Program

Foley & Lardner LLP on

On July 16, 2013, CMS announced results from the first performance year of the Pioneer Accountable Care Organization (ACO) Model. In the release, CMS reported that the Pioneer ACO participants held Medicare cost increases...more

King & Spalding

More Providers Form Accountable Care Organizations; Growth in Medicare Spending Continues to Decrease

King & Spalding on

On January 10, 2013, HHS Secretary Kathleen Sebelius announced that 106 new Accountable Care Organizations (ACOs) have formed and begun participating in the Shared Savings Program as of January 1, 2013....more

King & Spalding

Statistical Uncertainty in the Medicare Shared Savings Program

King & Spalding on

CMS has released the results of a recent analysis, published in Vol. 2, No. 4 of the Medicare & Medicaid Research Review, entitled Statistical Uncertainty in the Medicare Shared Savings Program....more

Mintz - Health Care Viewpoints

Medicare Shared Savings Program Grows by 106 ACOs in 2013

Yesterday the Centers for Medicare & Medicaid Services formally announced the 106 new Accountable Care Organizations (ACOs) participating in the 2013 Medicare Shared Savings Program (MSSP) cycle. CMS also announced that 15...more

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