The Recently Issued "Final" ACO Regulations

The long-awaited “Final” regulations on Accountable Care Organizations were recently issued by the Department of Health and Human Services. Revised legal guidance was also issued by the Office of Inspector General and the Centers for Medicare and Medicaid Services regarding fraud and abuse waivers, by the Federal Trade Commission and the Department of Justice regarding antitrust enforcement policy, and by the IRS regarding tax-exemption issues.

In response to over 1,300 public comments on the proposals back in April, the federal agencies made various revisions to the regulations with the objective of making ACO participation more attractive to hospitals and other providers.

The presenters will: (i) highlight “what’s new” in the final regulations and guidance; (ii) summarize how Medicare’s Shared Savings Program will work under the final regulations; and (iii) describe legal protections relating to fraud & abuse, antitrust and IRS issues in connection with ACOs.