ABA Health eSource April 2011 Volume 7 Number 8
ABA Health eSource - Your link to the ABA's Health Law Section
April 2011 Special Edition
Health Law Section NewsApril 28, 2011
April 29, 2011
ACOs and Antitrust: Spotlight on Proposed FTC/DOJ Policy Statement
(Free Teleconference &
In-person program)

May 4-6, 2011
Internal Corporate Investigations and Forum for
In-House Counsel 2011 -
New York, NY
(Live/In-person Program)

May 11-13, 2011
Health Care Fraud -
Miami, FL

(Live/In-Person Program)
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ACO Special Edition eSource

With the recent publication of the proposed regulations and commentary on Accountable Care Organizations (ACOs), the ABA eSource Editiorial Board in conjunction with the Section's ACO Task Force has decided to publish a series of Special Editions within the coming weeks focused on ACOs.  If you are interested in writing an article on a topic related to ACOs, please contact Simeon Carson, Associate Director, directly at simeon.carson@americanbar.org.

The ACO Task Force, chaired by Matthew Jenkins, Partner, Hunton & Williams LLP, was formed to address the myriad issues that surround the development of accountable care organizations, both in response to the provisions of PPACA and the interest of commercial payors in finding new ways to bend the cost curve. The Task Force has plans for several related projects in the coming months.

Membership in the the ACO Task Force is free for Health Law Section members. To join, please click here or contact Simeon Carson, Associate Director, at simeon.carson@americanbar.org.


ACO – Legal Structure, Governance and Leadership
By Andrew J. Demetriou, FULBRIGHT & Jaworski L.L.P., Los Angeles, CA and
J. A. (Tony) Patterson, Jr.,
FULBRIGHT & Jaworski L.L.P., Dallas, TX

This article will provide a brief overview of the key elements of the legal structure, governance and leadership of an Accountable Care Organization (“ACO”) that seeks to participate in the Medicare Shared Savings Program (“MSSP”) created under Section 3022 of the Patient Protection and Affordable Care Act of 2010 (“PPACA”). On March 31, 2011, the Centers for Medicare & Medicaid Services (“CMS”) proposed a rule, to be incorporated at 42 CFR Part 425 (the “Proposed Rule”), governing the formation of ACOs and their participation in the MSSP.

MORE Continue To Article


Free Teleconference: Friday, April 29, 2011, 1:00-2:00PM ET

ACOs and Antitrust: Spotlight on Proposed FTC/DOJ Policy Statement

Speakers:

  • Sharis A. Pozen, Deputy Assistant Attorney General, U.S. DOJ Antitrust Division
  • Susan S. DeSanti, Director, FTC Office of Policy Planning
  • Moderator: Robert F. Leibenluft, Hogan Lovells

The FTC and DOJ recently released new proposed guidance regarding Accountable Care Organizations (ACOs) who seek to participate in the Medicare Shared Savings Program. The proposal reflects close coordination with the Medicare program, and establishes both an antitrust safety zone for certain ACOs, as well as mandatory FTC or DOJ reviews for others that trigger minimum share thresholds.

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It’s all in the Math: Financial Mechanisms, Structures and Questions Under the Accountable Care Organization Proposed Regulations
By Alan S. Gassman, Gassman, Bates & Associates, P.A., Clearwater, FL; Mike Segal, Broad and Cassel, Miami, FL;
Martha Sosa, Gassman, Bates & Associates, P.A., Clearwater, FL,
and Dr. Pariksith Singh, CEO of Access Health Care, LLC, Spring Hill, FL 

This article discusses one of the most important aspects of Accountable Care Organizations (“ACOs”) – the potential financial rewards and risks under the Medicare Shared Savings Program (“MSSP”) pursuant to the proposed ACO regulations (the “Proposed ACO Regs”).

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Proposed Waivers for Application of Fraud and Abuse Laws
By Conrad Meyer, Chaffe McCall, L.L.P., New Orleans, LA

On April 7, 2011, the Department of Health and Human Services (“HHS”) and the Centers for Medicare & Medicaid Services (“CMS”) released a notice outlining proposed waivers addressing what an Accountable Care Organization (“ACO”) must do to participate in the Medicare Shared Savings Program created in the Patient Protection and Affordable Care Act. (PPACA”), including: ACO structure, eligibility, information technology (“IT”) requirements, antitrust issues, marketing, and tax implications.

MOREContinue To Article


Agencies Issue Antitrust Guidance for Medicare ACOs
By R. Brent Rawlings, McGuireWoods LLP, Richmond, VA

On March 31, 2011, the same day that CMS issued a proposed rulemaking for implementation of the Medicare Shared Savings Program (the “MSSP”), the Federal Trade Commission (“FTC”) and Department of Justice (“DOJ”) issued a Proposed Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program (the “Proposed Statement”).

MOREContinue To Article


Did you know membership in an interest group is FREE with your Health Law Section membership?

Did you know your membership in the ABA Health Law Section qualifies you for free membership in up to three interest groups of your choice? Interest groups, which are comprised of twelve practices areas within health law, make significant contributions to the Section's programming, publications and legislative initiatives. The interest groups also provide an excellent opportunity for you to interact with and have access to some of the most outstanding lawyers in the legal community. You can enroll on our webpage by clicking here. If you have any questions or need more information, please contact Simeon Carson at simeon.carson@americanbar.org


ACO Task Force

The ACO Task Force was formed to address the myriad issues that surround the development of accountable care organizations, both in response to the provisions of PPACA and the interest of commercial payors in finding new ways to bend the cost curve.

The IG is led by Chair Matthew Jenkins, Hunton & Williams LLP, Richmond, VA and Vice-Chairs William Boyd, Baylor Health Care System, Dallas, TX; Bernadette M. Broccolo, McDermott Will & Emery LLP, Chicago, IL and Robert F. Leibenluft, Hogan Lovells, Washington, DC.

If you would like to join the Interest Group, continue by clicking the following link: Health Law Section IG Sign-up Form.


ABA eSource Editorial Board

The ABA Health eSource Editorial Board is led by Chair Lisa Genecov, Locke Lord Bissell and Liddell LLP, Dallas, TX and editorial board members Michael E. Clark, Duane Morris LLP, Houston, TX; Adrienne Dresevic, The Health Law Partners, PC, Southfield, MI; Marla Durben Hirsch, Potomac, MD; Conrad Meyer, Chaffe McCall, LLP, New Orleans, LA and Jennifer Tsao, Hernandez Schaedel & Associates LLP, Pasadena, CA.


Do you want to communicate your ideas to thousands of other members? To contribute a newsletter article on a health law topic, send us your ideas to simeon.carson@americanbar.org.
The opinions expressed are those of the authors and shall not be construed to represent the policies or positions of the ABA or the ABA Health Law Section.
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