CMS recently released the federal regulations for accountable care organizations (ACOs); the 400-page-plus document addresses the many aspects of ACOs including legal structure and governance, shared savings calculations, antitrust enforcement, quality measures, payment models, and eligibility. This Webinar summarizes the proposed new ACO regulations, as well as the government's proposed waivers of the Stark and fraud and abuse laws, the proposed antitrust enforcement policy jointly issued by the DOJ and FTC, and the IRS's guidance for tax-exempt organizations participating in ACOs. It also provides updates on the new “Pioneer ACO” proposal from CMS, and explains some of the legal and financial implications for organizations planning to participate in the ACO program, if the proposed rule in its current form becomes final.

The following questions, among others, are covered in this program:

• What are the eligibility requirements for participating in an ACO?
• What quality information will need to be reported and measured and what are the standards for earning a share of savings?
• How will federal antitrust agencies enforce antitrust laws when competing healthcare providers create ACOs?
• How can tax-exempt entities participate in ACOs without jeopardizing their tax-exempt status through impermissible private inurement/private benefit?

Presenters: 

Anjana D. Patel and Gary W. Herschman, Sills Cummis & Gross P.C.

Members and Webinar participants may log in to view the recorded Webinar and download the slides. See download buttons, “Member Download” and “Start Course” above (buttons will not appear unless you are logged in with your member or participant password).

Below are links to download publications and articles related to this Webinar topic.

“A Value-Based Marathon Doesn’t Start with an ACO Sprint: A Board Member’s Guide to ACO Alternatives” (BoardRoom Press article, June 2011)

“Evolving to ACOs through Clinical Integration Programs” (E-Briefings Article, May 2011)

Leadership in the ACO Age: Creating, Governing, and Administering a Value-Based System of Care (white paper, Winter 2011)

“Accountable Care Organizations: The Challenge of Setting Strategy amid Uncertainty” (Webinar, September 2010)

“Hospital–Physician Integration” (Governance Spotlight DVD program, August 2010)