The American Hospital Association has urged CMS and HHS' Office of the Inspector General to finalize its current waivers for accountable care organizations from certain fraud and abuse laws without narrowing them, according to an AHA News Now report.
The waivers allow providers, including hospitals and physicians, within ACOs to collaborate in ways that could have violated Stark or other fraud and abuse laws without the waiver while protecting Medicare beneficiaries, according to the AHA.
Upon issuing the waivers, which went into effect upon their release, CMS and the OIG asked providers to provide comment on whether further narrowing or specification is needed. The AHA's response contends no further narrowing is needed. The AHA further argues the inclusion of the language regarding narrowing could give CMS and the OIG the ability to alter the waivers without a formal process that allows for comment. The AHA said in its comments, "Any material change in the waivers should be made only through formal, complete and specific notice-and-comment and should apply only to ACO agreements for which the pre-participation and participation phase arise after any changes are finalized."
Survey: 55% of Payors Plan to Participate in ACOs Over Next 3 Years
Cigna, Partners in Care Launch ACO in New Jersey
The waivers allow providers, including hospitals and physicians, within ACOs to collaborate in ways that could have violated Stark or other fraud and abuse laws without the waiver while protecting Medicare beneficiaries, according to the AHA.
Upon issuing the waivers, which went into effect upon their release, CMS and the OIG asked providers to provide comment on whether further narrowing or specification is needed. The AHA's response contends no further narrowing is needed. The AHA further argues the inclusion of the language regarding narrowing could give CMS and the OIG the ability to alter the waivers without a formal process that allows for comment. The AHA said in its comments, "Any material change in the waivers should be made only through formal, complete and specific notice-and-comment and should apply only to ACO agreements for which the pre-participation and participation phase arise after any changes are finalized."
Related Articles on ACOs:
NEJM: ACOs Won't Carry "Out of Shape" Hospitals to SuccessSurvey: 55% of Payors Plan to Participate in ACOs Over Next 3 Years
Cigna, Partners in Care Launch ACO in New Jersey