An article by Albany partner Matthew Amodeo titled, “The ACO Final Rule: Good News and Bad News for Physicians,” was published in BNA’s Medicare Report.
The Centers for Medicare & Medicaid Services (CMS) finally released the ACO Final Rule on Oct. 20, after more than 18 months of industry speculation.
Matt, a partner in the Health Law Practice Group, noted that “While many industry observers were anticipating an outright overhaul of the proposed ACO rules, the Final Rule is more of a refinement than a wholesale rewrite.”
Referring to the 1,300 comments on the draft rule CMS received from interested parties, Matt said, “What is clear in the Final Rule is that the industry spoke and CMS listened.”
In his article, he outlines both the good and bad news brought about by the Final Rule for physicians considering participating in the Medicare Shared Savings Program (SSP.)
Matt concludes that the changes in the Final Rule “are clearly intended to make participation in the SSP easier and more financially rewarding, not just for physicians, but for all providers.”
At this point, he says, it appears that CMS has accomplished these goals.
“It remains to be seen, however, whether the added flexibility under the Final Rule and relaxed legal constraints under the Fraud & Abuse Waivers will result in hospitals and other ACO participants flexing their economic muscle at the expense of physician leadership and control of ACOs,” he finished.