The Medicare ACO Proposed Rule: Legal Structure, Governance, and Regulatory Sections, in Health Affairs Blog

Doug Hastings, Chair of the Board of Directors and based in the Washington, DC, office, wrote a column titled "The Medicare ACO Proposed Rule: Legal Structure, Governance, And Regulatory Sections."

Following is an excerpt:

In the recently released Proposed Rule on ACOs and the Medicare Shared Savings Program, important sections relate to the legal structure and governance of accountable care organizations (ACOs) and certain key regulatory issues affecting ACOs—antitrust, fraud and abuse, and exempt organization tax law. It is apparent that significant intergovernmental agency cooperation and coordination has gone into the production of the Proposed Rule, including among the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services Office of Inspector General (OIG), the Department of Justice (DOJ), the Federal Trade Commission (FTC), and the Internal Revenue Service (IRS).

The result will not satisfy all stakeholders, but it constitutes a comprehensive effort that will help (1) create more consistency in the treatment of these issues by regulators, (2) foster a better understanding by the industry of what is required by CMS and the other agencies, and (3) indicate how enforcement agencies will view ACO activities in both the Medicare and commercial markets. Moreover, stakeholders have until June 6 to provide comments to CMS on the Proposed Rule (May 31 to FTC/DOJ and IRS) and should avail themselves of that opportunity.