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  • APTA Seeks Member Input for ACO Comments

    To ensure that APTA's comments on the proposed regulations on Accountable Care Organizations (ACO) are comprehensive and appropriately address concerns specific to physical therapy, APTA is soliciting member input on the new model of care and the proposals that address the federal laws related to it.    

    On March 31, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited ACO proposed rule. In creating the proposed ACO model, CMS worked closely with the Department of Health and Human Services, Office of the Inspector General, Federal Trade Commission, Department of Justice, and Internal Revenue Service to align and implement a shared savings program that did not conflict with existing federal laws in the area of fraud and abuse, antitrust, and tax exemptions. Therefore, the proposed ACO regulations are promulgated in 4 separate rulemakings: (1) CMS Medicare Shared Savings Program Proposed Rule, (2) CMS/Office of the Inspector General Waiver of Fraud and Abuse Certain Provisions Notice with Comment Period, (3) Federal Trade Commission/Department Of Justice Anti-trust Enforcement Policy Notice with Comment Period, and (4) Internal Revenue Service Request for Information on Tax-Exempt Status for Shared Savings Programs.

    APTA's comments will primarily focus on 10 subject areas:

    1. quality
    2. promoting evidence based medicine
    3. health information technology
    4. legal and governance structure of ACOs
    5. leadership and management of ACOs
    6. ACO distribution of shared savings and losses
    7. ACO marketing guidelines
    8. program integrity requirements for ACOs (audit activities)
    9. fraud and abuse requirements for ACOs (including physician self-referral, and anti-kickback rules)
    10. safeguards for physical therapists operating outside an ACO

    APTA has summarized the provisions of each proposed rulemaking for association members. A new podcast also provides highlights of the ACO model of care.   

    APTA will submit comments to CMS by the June 6 deadline. E-mail your input to APTA at ACOcomments@apta.org by May 15. In your e-mail, indicate which of the above subject areas that your comments are regarding.


    • Concerns from a private practice independent physcial therapy business onwer: (1) relaxing anti-trust regulations to allow for collusion between physician groups and hospitals spell trouble for indpendent practice owners.(2) in Oregon they are developing CCO's (coordinated care organizations) initially for medicaid and medicare patients soon to follow all state and city employees. Larger groups; hospital based PT programs, POPTs and intra-state national companies will leverage out independent PT practitioners with contracted volume discounts, case rate plans and capitated contracts. This leads to PT extenders providing the bulk of care and those that provide the least care survive financially. Is this a future to embrace/support?

      Posted by Rockwood Reid -> AIT^@ on 4/29/2011 11:41 AM

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