Dive Brief:
- Accountable Care Organizations taking part in the Medicare Shared Savings Program received an extension on waivers enforcing fraud and abuse laws for the organizations. The final rule on the waivers was supposed to be released in Nov. 2014, but has been extended for one year.
- There were five waivers provided for some ACOs that include a pre-participation waiver, a participation waiver, shared savings distribution waiver, compliance with the Physician Self-Referral law and patient incentive waiver.
- The statement was released by the Centers for Medicare and Medicaid Services, the Department of Health and Human Services and the Office of the Inspector General. The departments said modifications will be necessary but more time is needed to ensure that they all align. An extension would also avoid legal uncertainty for ACOs in the program and continue to foster enrollment.
Dive Insight:
According to a press release by Hayes and Boone LLP, the CMS released a statement saying "Our decision to extend the Waiver IFC, rather than issue a final rule at this time, should not be viewed as a diminution of the Department's commitment to establish waivers 'to foster the success of the Shared Savings Program, the purposes of which are to promote accountability for a Medicare patient population, manage and coordinate care for Medicare fee-for-service beneficiaries, and encourage redesigned care processes to improve quality.'"
The law firm reported that CMS is seeking stakeholder input into the way ACOs are using the waivers; if the waivers serve the needs of the ACOs; if the waivers properly protect the Medicare program and its beneficiaries; and if there are new considerations that should inform the development of rulemaking regarding the waivers.