December 13, 2011
In the final Shared Savings Program regulations released by Centers for Medicare and Medicaid Services (CMS) on Oct. 20, 2011, (the “Final Rule”), CMS reconsidered many of its core positions set forth in the proposed regulations issued March 2011, with the goal of reducing burdens and costs for participating in the Medicare Shared Savings Program (MSSP). Below we focus on these changes as they relate to another key piece: Who must govern Accountable Care Organizations (ACOs), and how must they be structured?
ACO Governance
Generally, CMS retained many of its proposed limitations on how an ACO may structure its governing body, though the changes made in the Final Rule do create added flexibility for a participating ACO. Specifically:
ACO Structure
As with the governance requirements, CMS retained many of its proposed regulations on limitations on how an ACO may be structured and who may participate, with minor clarifications. Specifically:
Although the changes included in the Final Rule provide additional flexibility, CMS has by-and-large retained the requirements for ACO governance and legal structure included in the proposed regulations. It remains to be seen whether these and other changes will be sufficient to encourage more providers to participate in the MSSP in the near future or longer term.