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2016-02-03
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Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations
Part II
Proposed Rules
D09002ee1c26b2422
D09002ee1c26b2522
United States
Department of Health and Human Services
originator
org
United States Government Agency or Subagency
United States
Centers for Medicare & Medicaid Services
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org
United States Government Agency or Subagency
Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This proposed rule addresses changes to the Shared Savings Program that would modify the program's benchmark rebasing methodology to encourage ACOs' continued investment in care coordination and quality improvement, and identifies publicly available data to support modeling and analysis of these proposed changes. In addition, it would streamline the methodology used to adjust an ACO's historical benchmark for changes in its ACO participant composition, offer an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program, and establish policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined.
81 FR 5824
https://www.govinfo.gov/app/details/FR-2016-02-03/2016-01748
2016-01748
fr03fe16-24
RIN 0938-AS67
4120-01-P
CMS-1644-P
https://www.govinfo.gov/app/details/FR-2016-02-03/2016-01748
https://www.govinfo.gov/content/pkg/FR-2016-02-03/html/2016-01748.htm
https://www.govinfo.gov/content/pkg/FR-2016-02-03/pdf/2016-01748.pdf
Administrative Practice and Procedure
Health Facilities
Health Professions
Medicare
Reporting and Recordkeeping Requirements
49 p.
5824
5872
81 FR 5824
Code of Federal Regulations
Title 42 Part 425
42 CFR Part 425
Regulation Identification Number 0938-AS67
RIN 0938-AS67
Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations-Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations; Federal Register Vol. 81, Issue
PRORULE
2016-01748
II
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
2016-03-28
CMS-1644-P
4120-01-P
2016-01748
Proposed rule.
Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This proposed rule addresses changes to the Shared Savings Program that would modify the program's benchmark rebasing methodology to encourage ACOs' continued investment in care coordination and quality improvement, and identifies publicly available data to support modeling and analysis of these proposed changes. In addition, it would streamline the methodology used to adjust an ACO's historical benchmark for changes in its ACO participant composition, offer an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program, and establish policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined.
To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on March 28, 2016.
Elizabeth November, (410) 786-8084.
Administrative Practice and Procedure
Health Facilities
Health Professions
Medicare
Reporting and Recordkeeping Requirements
Medicare Program; Medicare Shared Savings Program:
Accountable Care OrganizationsRevised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations
,
aco@cms.hhs.gov
Data.CMS.gov
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Financial-and-Assignment-Specifications.html
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Updating-ACO-Participant-List.html
http://www.gao.gov/special.pubs/01765G/vol1_complete.pdf
http://www.regulations.gov
http://www.sba.gov/content/small-business-size-standards
https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/downloads/Advance2010.pdf
https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/EarlyPreview2017GrowthRates.pdf
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/Reconsideration-Review-Process-Guidance.pdf
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Statutes-Regulations-Guidance.html
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-01-11-2.html
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/mc86c08.pdf
www.cms.gov/sharedsavingsprogram/:
www.regulations.gov
Federal Register
Vol. 81, no. 22
Office of the Federal Register, National Archives and Records Administration
2016-02-03
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316 p.
Table of Contents:
AE 2.7:
GS 4.107:
AE 2.106:
KF70.A2
https://www.govinfo.gov/app/details/FR-2016-02-03
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0042-1219
0364-1406
769-004-00000-9
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https://www.govinfo.gov/app/details/FR-2016-02-03
https://www.govinfo.gov/content/pkg/FR-2016-02-03/pdf/FR-2016-02-03.pdf
https://www.govinfo.gov/content/pkg/FR-2016-02-03/xml/FR-2016-02-03.xml
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2016-02-03
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FR-2016-02-03
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