Monday, June 2, 2014

CMS to Propose New ACO Rules before Summer

James Michel

According to the Spring 2014 update to the Department of Health and Human Services’ Regulatory Agenda, the agency plans to publish new proposed rules for the Medicare Shared Savings Program (MSSP), which regulates Accountable Care Organizations (ACOs).

According to CMS, “This proposed rule would address changes to the MSSP and contains provisions relating to Medicare payments to providers of services and suppliers participating in ACOs under the MSSP. These changes would apply to existing ACOs and approved ACO applicants participating in the program beginning January 1, 2016.”

The Regulatory Agenda also lists an updated rule pertaining to fraud and abuse waivers provided to Medicare ACOs. Both of these new rules could have significant implications for skilled nursing and other post-acute providers who currently work with ACOs. AHCA will analyze these rules once they are published and will respond with official comments to CMS. Just recently AHCA released an ACO Contracting Guide for SNF Providers, which provides a robust discussion of the current ACO rules. Members can access the tool here.

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