The Patient Protection and Affordable Care Act of 2010 (PPACA) encourages the development of new patient care models designed to improve the coordination, quality, and efficiency of healthcare services to Medicare and Medicaid patients. One of the primary initiatives for delivery model innovation under PPACA is the Medicare Shared Savings Program, commonly referred to as Accountable Care Organizations (ACOs). To assist in the creation of ACOs, PPACA grants the Secretary of Health and Human Services the authority to waive certain provisions of the fraud and abuse laws under the Social Security Act or other provisions of Medicare law (ACO waivers).
The Public Interest Committee of AHLA has authored a concise outline - Waivers Under the Medicare Shared Savings Program: An Outline of the Options - describing possible approaches the Secretary for the Department of Health and Human Services can consider in crafting ACO waivers. This Outline addresses a range of ACO waiver options, listing the pros and cons of each method. It does not provide an exhaustive review of all waiver options nor does it list every permutation of each option.
The Public Interest Committee is very grateful for the following individuals who provided their time and expertise on this very timely topic: Douglas A. Hastings
Robert G. Homchick
Peter M. Leibold
Arthur N. Lerner
Lisa D. Vandecaveye
Letter to Daniel R. Levinson, Inspector General, DHHS
Letter to Donald M. Berwick, Administrator, CMS