Affordable Care Act, Medicare Shared Savings Program

CMS Reports Medicare Shared Savings Program Saved Medicare $1.66 Billion in 2021

Foley & Lardner LLP on 9/7/2022

On August 30, 2022, the Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) had saved the Medicare program $1.66 billion in 2021 as compared to spending targets, while...more

Proposed Revisions to Medicare Shared Savings Program: CMS Encourages Participation

Foley & Lardner LLP on 8/24/2022

The Centers for Medicare and Medicaid Services (CMS), as part of 2023 Physician Fee Schedule proposed rule, has proposed significant revisions to the Medicare Shared Savings Program (MSSP). The revisions to the MSSP in the...more

A Review of the Affordable Care Act at 10 Years, Part 4: Alternative Payment and Delivery Models

Mintz - Health Care Viewpoints on 4/14/2020

Today's post is the last in our series on the 10-year anniversary of the Affordable Care Act (ACA). While the Congress that passed the ACA recognized that health care delivery reform was necessary, the law included few...more

Healthcare Law Review: Overview of the U.S. Healthcare System

Foley & Lardner LLP on 10/11/2019

The U.S. healthcare industry remains at a crossroads. The healthcare reform legislation passed under President Barack Obama in 2010, officially called the Patient Protection and Affordable Care Act (ACA) but widely referred...more

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

K&L Gates LLP on 1/31/2019

As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

Top 5 Takeaways: CMS’s Proposed Overhaul of the MSSP ACOs

McDermott Will & Emery on 9/4/2018

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on August 17, 2018, that would make sweeping changes to the Medicare Shared Savings Program (MSSP), a federal program that incentivizes integrated...more

CMS Finalizes Mandatory Cardiac Care Bundled Payment Model and More

Foley & Lardner LLP on 1/3/2017

On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (the Final Rule) which includes three new mandatory episode-based payment programs for cardiac care, as well as the expansion of the...more

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

Pierce Atwood LLP on 11/22/2016

On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more

Health Law Insights Newsletter - Issue 13

McCarter & English, LLP on 10/17/2016

McCarter & English, LLP’s Health Care Group presents Issue 13 of the Health Law Insights, which discusses the latest legal issues in the health care industry. - Failure to Update Business Associate Agreement Results in...more

IRS Denies Exempt Status for Non-MSSP Accountable Care Organizations

Foley & Lardner LLP on 7/15/2016

In April, the IRS released a private letter ruling denying section 501(c)(3) status to an accountable care organization (“ACO”) that contracted with third-party payers outside of the Medicare Shared Savings Program (“MSSP”)....more

APMs, MIPS, and the Final MSSP Rule - The Journey from Volume to Value-Based Reimbursement Continues

Pierce Atwood LLP on 6/20/2016

Since the Affordable Care Act was enacted, many providers have been shifting away from traditional fee-for-service, volume-based reimbursement models to payment mechanisms that take a data-driven approach to managing patients...more

American Hospital Association Urges IRS To Affirm that Tax-Exempt Hospitals Can Participate in Non-Medicare ACOs

King & Spalding on 6/1/2016

The American Hospital Association (AHA) has written to John Koskinen, Commissioner of the Internal Revenue Service (IRS), and Mark Mazur, Assistant Secretary for Tax Policy at the Treasury Department, raising concerns about...more

IRS Ruling Sounds Alarm over Tax-Exempt Status of Nonprofit ACOs Operating outside of the Medicare Shared Savings Program

Cadwalader, Wickersham & Taft LLP on 5/11/2016

On April 8, 2016, the IRS released private letter ruling 201615022 denying tax-exempt section 501(c)(3) status to a nonprofit accountable care organization (“ACO”) that did not participate in the Medicare Shared Savings...more

IRS Denial of Section 501(c)(3) Status for a Commercial ACO

Sheppard Mullin Richter & Hampton LLP on 5/10/2016

The IRS recently released a ruling, Private Letter Ruling (“PLR”) 201615022, denying Section 501(c)(3) tax-exempt status to a “commercial” accountable care organization (“ACO”). This is the IRS’ first published guidance...more

Health Update - February 2016

Manatt, Phelps & Phillips, LLP on 2/26/2016

Better Late Than Never: CMS Provides Much-Needed Clarity on the 60-Day Overpayment Refund Requirements - On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited final rule (Final...more

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

King & Spalding on 9/21/2015

Final ACO Fraud Waiver Under OMB Review – The White House Office of Management and Budget (OMB) reported on September 9, 2015, that it began its review of the final rule (CMS-1439-F; RIN 0938-AR30), titled “Medicare Shared...more

CMS Issues CY 2016 Medicare Physician Fee Schedule Proposed Rule

King & Spalding on 7/22/2015

On July 8, 2015, CMS issued its annual proposed rule outlining payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for CY 2016. In the proposed rule,...more

Health Update - June 2015

Manatt, Phelps & Phillips, LLP on 6/23/2015

Examining Fee Splitting Statutes in the Context of Value-Based Healthcare - Editor’s note: One of the goals of the Affordable Care Act (ACA) is to align incentives among provider communities and their patients and...more

ACOs: The Next Generation of Coordination Care

BakerHostetler on 6/23/2015

An Overview of the Medicare Shared Savings Program/Accountable Care Organization Final Rules - The Centers for Medicare and Medicaid Services (CMS) recently released a final rule (Final Rule) that makes changes to the...more

ACOs: The Next Generation of Coordinated Care - An Overview of the Medicare Shared Savings Program/Accountable Care Organization...

BakerHostetler on 6/22/2015

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule (Final Rule) that makes changes to the Medicare Shared Savings Program (MSSP). The Affordable Care Act (ACA) created the MSSP as one of...more

Patient Protection and Affordable Care Act (PPACA) › Medicare Shared Savings Program