CMS Redesigns Medicare ACOs to be More Appealing to Physicians

October 31, 2011 – In The News
American Medical News

After receiving much criticism on the Medicare accountable care organizations plan, the Obama administration made their final rule, removing several proposed conditions in effort to make the new model more enticing to physicians.

The final ACO rule was supplemented with guidance documents from the Justice Dept., Federal Trade Commission, Internal Revenue Service and Health and Human Services Office of Inspector General, which removed a provision mandating a regulatory antitrust review of ACOs.

However, it's clear that the FTC and Justice Dept. still will be actively monitoring ACOs, said William Maruca, a health care attorney at Fox Rothschild in Pittsburgh. Federal regulators will be open to investigating complaints, which probably would come from smaller groups or employers, against large ACOs engaged in anti-competitive practices. "If you cross the line, they will come after you," Maruca said.

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