ACO Regulations are Released

Monday, April 11th, 2011

The Administration issued its long awaited Medicare Shared Savings/Accountable Care Organization (ACO) regulation on Mar. 31. The Medicare ACO program is a voluntary, three-year program to further develop the ACO model of health care delivery reform. The Centers for Medicare and Medicaid Services (CMS) issued the proposed regulation and comments are due on June 6. Prior to the release, CMS Administrator Don Berwick, MD, reached out to AMA leadership to emphasize the Administration’s interest in our comments. CMS and the Office of the Inspector General (OIG) also issued a joint solicitation of comments on proposed waivers for Medicare ACOs from the self-referral, anti-kickback, and civil monetary penalties statutes. The Federal Trade Commission (FTC) and the Department of Justice (DOJ) issued a proposed policy statement on antitrust and ACOs, and the Internal Revenue Service (IRS) issued a notice pertaining to tax-exempt entities, as well. All these agencies are providing opportunities for the public to comment. The AMA is reviewing the hundreds of pages of these documents in-depth and will be working with the Federation in developing comments.

The documents can be viewed at:

• CMS proposed rule on ACOs:

http://www.ofr.gov/OFRUpload/OFRData/2011-07880_PI.pdf

• CMS/ OIG notice on waiver designs:

http://www.ofr.gov/OFRUpload/OFRData/2011-07884_PI.pdf

• FTC/ DOJ notice on antitrust enforcement policy and ACOs:

http://www.ftc.gov/os/fedreg/2011/03/110331acofrn.pdf

• IRS notice on ACO participation by tax-exempt organizations:

http://www.irs.gov/pub/irs-drop/n-11-20.pdf

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