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Making Accountable Care a Reality: Multiple Federal Agencies Issue Proposed Guidance on the Medicare Shared Savings Program

by Shawn M. Gilman, Douglas A. Hastings, Mark E. Lutes, David E. Matyas, Lynn Shapiro Snyder, Carrie Valiant, Dale C. Van Demark, Patricia M. Wagner, and Lesley R. Yeung

On March 31, 2011, the Centers for Medicare & Medicaid Services (“CMS”) released for public comment a much-anticipated Notice of Proposed Rulemaking implementing the voluntary Medicare Shared Savings Program (“Program”) for accountable care organizations (“ACOs”). Also on March 31, the Office of Inspector General, along with CMS, released a Notice with Comment Period to solicit comments regarding proposed waivers from the federal health care program fraud and abuse laws for provider payments made in connection with the Program. On the same day, the Federal Trade Commission and the Department of Justice issued a Notice with Comment Period soliciting comments regarding a “Proposed Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program,” and the Internal Revenue Service issued a notice outlining its analysis of tax-exempt organization participation in Medicare ACOs.

Below, we link to the first alert in a series that will examine these regulatory issuances as well as future government pronouncements, including those currently being formulated by the Center for Medicare and Medicaid Innovation, which was established under the Patient Protection and Affordable Care Act to test innovative payment and service delivery models to reduce federal program expenditures.

Download the full alert (PDF) Read the full alert online