ACOs Get Broad Waivers from the Fraud & Abuse Laws

McDermott Will & Emery
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The Centers for Medicare & Medicaid Services and the Office of the Inspector General (HHS) have issued, and seek public comment on, broad waivers of the federal fraud and abuse laws for ACOs seeking to participate in the Medicare Shared Savings Program.

On October 20, 2011, the Centers for Medicare & Medicaid Services (CMS) and the Office of the Inspector General, Department of Health and Human Services (OIG) (collectively, the Agencies) issued for public inspection an interim final rule with comment period (the Final ACO Waivers Rule) setting forth the scope, terms and conditions of waivers of four federal laws that would otherwise prohibit or impede the development and operation of accountable care organizations wishing to participate in the Medicare Shared Savings Program (the Shared Savings Program). The release of the Final ACO Waivers Rule was concurrent with the release of the final rule for the Medicare Shared Savings Program (the Final ACO Rule). Both rules were published in the Federal Register on November 2, 2011 and, while the Medicare Shared Savings Program (the Final ACO Rule) is effective January 3, 2011, the Final ACO Waivers Rule is effective November 2, 2012. Comments on Final ACO Waivers Rule are due no later than 5 p.m. on January 3, 2012.

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