HHS and CMS Issue Proposed Rule on Accountable Care Organizations
By JAMES F. OWENS, PAUL A. GOMEZ, & JOSH R. HILL
On March 31, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) released the highly anticipated proposed rule under the Affordable Care Act of 2010 (commonly referred to as the Healthcare Reform Law) regarding the formation and operation of accountable care organizations (ACOs). The proposed rule, which will be published in the Federal Register on April 7, 2011, is the predecessor to the final rule that will be issued by HHS/CMS sometime after the 60 day public comment period (which began on March 31).
In addition, because the proposed rule will necessitate certain changes to the current regulatory framework, CMS issued a joint notice related to waivers of the federal physician self-referral law, anti-kickback statute, and the civil monetary penalty law related to the Shared Savings Program (the Program); the FTC and DOJ also jointly issued a "Proposed Statement of Enforcement Policy Regarding Accountable Care Organizations Participating in the Shared Savings Program;" and the IRS issued a notice requesting comments regarding participation by tax-exempt organizations, including hospitals, in ACOs in the Program.