Three documents summarizing the final rules issued last week for Accountable Care Organizations (ACOs) have been posted to www.apta.org/ACO.
The Medicare Shared Savings Program (MSSP) summary provides the definition of an ACO, an ACO participant, an ACO professional, an ACO provider/supplier, and primary care services. Physical therapists in private practice, home health agencies, skilled nursing facilities, and rehabilitation agencies would be considered for purposes of the ACO regulations an ACO provider/supplier. The summary also discusses ACO agreements with the Centers for Medicare and Medicaid Services (CMS), describes reporting requirements, and details the application process.
A summary of the interim final rule addressing the 5 fraud and abuse waivers that apply to the MSSP are summarized in a separate document. CMS and the Department of Health and Human Services Office of the Inspector General are seeking comments on this interim final rule by January 2, 2012.
Additionally, APTA provides highlights of the Federal Trade Commission and Antitrust Division of the Department of Justice's final joint statement about how the agencies will enforce the antitrust laws as they relate to ACOs. The joint policy statement describes: (1) the ACOs to which it applies; (2) an antitrust safety zone for certain ACOs; and (3) the antitrust review process for ACOs that do not fit into the safety zone.