Health Center Regulatory Issues

CMS Releases Final Rule on Accountable Care Organizations

Last week CMS issued its final rule on the Medicare Shared Savings Program and Accountable Organizations (ACOs).  This rule encompasses a number of important changes for the Medicare ACO program, which you can read about in the final rule and fact sheet.   While we are still going through the rule more thoroughly, we wanted to let you know about several health center specific issues that were addressed.  You may remember that NACHC submitted comments on this proposed rule.  Specifically NACHC’s comments focused on the following areas:

  • Supporting the proposed rule that would allow primary care visits from non-physician providers (NPs, PAs, and CNSs) to count earlier in the beneficiary assignment process for FQHCs
  • Requesting that primary care visits with only non-physician providers be considered “assignable” to ACOs
  • Requesting that CMS maintain the requirement that 75 percent of the ACO board members be providers.

NACHC was pleased to see that CMS accepted many of our comments in the final rule, allowing for non-physician providers to count earlier in the beneficiary assignment process and maintaining the 75 percent requirement that board members be providers.

ACOs play an important role in improving care coordination, and we were pleased to see these important changes for health centers.  We believe that these changes will help to encourage more health center participation in ACOs and will continue to review the rule and update you on any additional issues that are relevant to health centers’ participation.