The Centers for Medicare & Medicaid Services ("CMS") released a final rule ("Final Rule") on the Medicare Shared Savings Program ("MSSP") (Fed. Reg. Vol. 80, No. 110, 32692-32845), which contained good news for accountable care organizations ("ACOs"). Not only did the Final Rule incorporate informal guidance that CMS had previously issued, it also responded to many of the comments provided during the comment period, most notably the ability for ACOs to continue for one more contract cycle in a shared savings agreement (called Track 1 by CMS). Previously, ACOs would have had to accept downside financial risk if they were continuing in the MSSP and entered into a Track 2 agreement. In the press release and fact sheet accompanying the Final Rule, CMS highlighted its "support for the care provider community in creating a delivery system with better care, smarter spending, and healthier people."
The Final Rule continues the existing MSSP model in which providers and suppliers participating in ACOs receive traditional Medicare Parts A and B fee-for-service payments and are eligible to receive shared savings if certain quality and savings targets are met. The Final Rule added the following changes to improve the program:
The Final Rule also clarified and formalized prior guidance in a number of areas, including requirements related to:
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