November 2011

Accountable Care Organizations: Summary of Final Regulations

A Polsinelli Shughart Update

The Final Rules related to Section 3022 of the Patient Protection and Affordable Care Act (PPACA) and the “shared savings” program were promulgated by several federal departments in a coordinated manner on October 28, 2011, including:

• The Centers for Medicare & Medicaid Services (CMS) (addressing Section 3022) (the “Shared Savings Final Rule”)
  
• CMS and the Office of Inspector General, U.S. Department of Health and Human Services (OIG) (addressing waivers of certain prohibitions directed at health care fraud and abuse) (the “Interim Final Rule”)
  
• The Federal Trade Commission (FTC) and U.S. Department of Justice, Antitrust Division (DOJ) (addressing antitrust concerns) (the “Antitrust safety zone”)
  
• The Internal Revenue Service (IRS) (considering tax-exempt organization issues)

While the text of the Final Rules comprises over 800 double-spaced pages, you may access a high-level summary of the Final Rules by clicking here. The summary is organized to address the following:

• Who may participate in the shared savings program
  
• What are the major requirements and opportunities relating to the structure and operation of ACOs and their participation in the shared savings program
  
• How the shared savings program will operate for ACOs with participation agreements with CMS
  
• Practical implications of the Final Rules

In addition, Polsinelli Shughart Health Care attorneys presented a webinar titled, “Final Rule: Accountable Care Organizations.” A recording of the presentation, including presenter slides, can be accessed by clicking here.

For More Information

If you would like more information on this topic, please contact:

• Bruce A. Johnson | 303.583.8203 | brucejohnson@polsinelli.com
• Janice A. Anderson | 312.873.3623 | janderson@polsinelli.com
• Gerald A. Niederman | 303.583.8204 | gniederman@polsinelli.com
• Alan K. Parver | 202.626.8306 | aparver@polsinelli.com

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